Low circulating musclin is associated with adverse prognosis in patients undergoing transcatheter aortic valve implantation at low‐intermediate risk

  • Background: Musclin is an activity‐stimulated and cardioprotective myokine that attenuates pathological cardiac remodeling. Musclin deficiency, in turn, results in reduced physical endurance. The aim of this study was to assess the prognostic value of circulating musclin as a novel, putative biomarker to identify patients undergoing transcatheter aortic valve implantation (TAVI) who are at a higher risk of death. Methods and Results: In this study, we measured systemic musclin levels in 368 patients undergoing TAVI who were at low to intermediate clinical risk (median EuroSCORE [European System for Cardiac Operative Risk Evaluation] II: 3.5; quartile 1–quartile, 2.2%–5.3%), whereby 209 (56.8%) patients were at low and 159 (43.2%) were at intermediate risk. Median preprocedural musclin levels were 2.7 ng/mL (quartile 1–quartile 3, 1.5–4.6 ng/mL). Musclin levels were dichotomized in low (<2.862 ng/mL, n=199 [54.1%]) or high (≥ 2.862 ng/mL, n=169 [45.9%]) groups using cutoff values determined by classification and regression tree analysis. The primary end point was 1‐year overall survival. Patients with low circulating musclin levels exhibited a significantly higher prevalence of frailty, low albumin values, hypertension, and history of stroke as well as higher N‐terminal pro‐B‐type natriuretic peptide. Low musclin levels significantly predicted risk of death in univariable (hazard ratio, 1.81; 95% CI, 1.00–3.53 [P=0.049]) and multivariable (adjusted hazard ratio, 2.45; 95% CI, 1.06–5.69 [P=0.037]) Cox regression analyses. Additionally, low musclin levels in combination with conventional EuroSCORE II suggested improved risk stratification in patients undergoing TAVI who were at low to intermediate clinical risk into subgroups with reduced 1‐year survival rates by log‐rank test (P for trend=0.003). Conclusions: Circulating musclin is an independent predictor of 1‐year overall survival in patients undergoing TAVI. Combined with EuroSCORE II, circulating musclin might help to improve prediction of mortality in patients undergoing TAVI who are at low to intermediate clinical risk.

Download full text files

Export metadata

Metadaten
Author:Badder KattihORCiDGND, Daniel C. CarstensORCiD, Felicitas Juana BöcklingGND, Tina Rasper, Graziella Pergola, Stefanie DimmelerORCiDGND, Mariuca Vasa‐NicoteraORCiDGND, Andreas M. ZeiherORCiDGND, Silvia Mas-PeiroORCiDGND
URN:urn:nbn:de:hebis:30:3-751686
DOI:https://doi.org/10.1161/JAHA.121.022792
ISSN:2047-9980
Parent Title (English):Journal of the American Heart Association
Publisher:Association
Place of publication:New York, NY
Document Type:Article
Language:English
Date of Publication (online):2022/03/01
Date of first Publication:2022/03/01
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2024/08/19
Tag:TAVI; aortic valve stenosis; biomarker; musclin
Volume:11
Issue:6, art. e022792
Article Number:e022792
Page Number:11
First Page:1
Last Page:11
HeBIS-PPN:521205417
Institutes:Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Sammlungen:Universitätspublikationen
Licence (German):License LogoCreative Commons - CC BY-NC-ND - Namensnennung - Nicht kommerziell - Keine Bearbeitungen 4.0 International