Dipeptidyl peptidase IV and Mortality After an Acute Heart Failure Episode

作者：Lourenco Patricia^*; Frioes Fernando; Silva Nuno; Guimaraes Joao Tiago; Bettencourt Paulo

来源：Journal of Cardiovascular Pharmacology, 2013, 62(2): 138-142.

DOI：10.1097/FJC.0b013e3182949673

• heart failure
• dipeptidyl peptidase IV
• natriuretic peptides
• natriuretic paradox

Background: Dipeptidyl peptidase IV (DPP IV) is a key enzyme in B-type natriuretic peptide processing. DPP IV was never studied in human heart failure (HF). We aimed to measure DPP IV concentration in acute HF and determine its association with mortality. %26lt;br%26gt;Methods and Results: Patients hospitalized with acute HF were eligible. We excluded patients with acute coronary syndromes. A discharge blood sample was collected from all patients and they were followed for a 6-month period. Outcome was HF death. Patients were compared across DPP IV quartiles. A Cox regression analysis was used to assess the prognostic power of DPP IV. We studied 164 patients. Median age was 78 years, 48.8% were men, and 63 had type 2 diabetes and 59.1% had left ventricular systolic dysfunction. Quartiles of DPP IV were %26lt;215.2; 215.2 and %26lt;269.3; 269.3 and %26lt;348.6; and 348.6 ng/mL; groups were homogenous between them. Seventeen patients died. Patients with DPP IV in the last quartile had a hazard ratio of HF death up to 6 months of 2.89, 95% confidence interval, 1.11-7.46. Association was B-type natriuretic peptide independent. %26lt;br%26gt;Conclusions: Discharge DPP IV 348.6 ng/mL conferred an approximately 3-fold higher risk of 6-month HF death. Further studies would be important to understand the role of DPP IV in HF.

• 出版日期2013-8