Bloodstream Amyloid-beta (1-40) Peptide, Cognition, and Outcomes in Heart Failure.

Published

Journal Article

INTRODUCTION AND OBJECTIVES: In the brain, amyloid-beta generation participates in the pathophysiology of cognitive disorders; in the bloodstream, the role of amyloid-beta is uncertain but may be linked to sterile inflammation and senescence. We explored the relationship between blood levels of amyloid-beta 1-40 peptide (Aβ40), cognition, and mortality (all-cause, cardiovascular, and heart failure [HF]-related) in ambulatory patients with HF. METHODS: Bloodstream Aβ40 was measured in 939 consecutive patients with HF. Cognition was evaluated with the Pfeiffer questionnaire (adjusted for educational level) at baseline and during follow-up. Multivariate Cox regression analyses and measurements of performance (discrimination, calibration, and reclassification) were used, with competing risk for specific causes of death. RESULTS: Over 5.1 ± 2.9 years, 471 patients died (all-cause): 250 from cardiovascular causes and 131 HF-related. The median Aβ40 concentration was 519.1 pg/mL [Q1-Q3: 361.8-749.9 pg/mL]. The Aβ40 concentration correlated with age, body mass index, renal dysfunction, and New York Heart Association functional class (all P < .001). There were no differences in Aβ40 in patients with and without cognitive impairment at baseline (P = .97) or during follow-up (P = .20). In multivariable analysis, including relevant clinical predictors and N-terminal pro-B-type natriuretic peptide, Aβ40 remained significantly associated with all-cause death (HR, 1.22; 95%CI, 1.10-1.35; P < .001) and cardiovascular death (HR, 1.18; 95%CI, 1.03-1.36; P = .02), but not with HF-related death (HR, 1.13; 95%CI, 0.93-1.37; P = .22). Circulating Aβ40 improved calibration and patient reclassification. CONCLUSIONS: Blood levels of Aβ40 are not associated with cognitive decline in HF. Circulating Aβ40 was predictive of mortality and may indicate systemic aging.

Full Text

Duke Authors

Cited Authors

  • Bayes-Genis, A; Barallat, J; de Antonio, M; Domingo, M; Zamora, E; Vila, J; Subirana, I; Gastelurrutia, P; Pastor, MC; Januzzi, JL; Lupón, J

Published Date

  • November 2017

Published In

Volume / Issue

  • 70 / 11

Start / End Page

  • 924 - 932

PubMed ID

  • 28279654

Pubmed Central ID

  • 28279654

Electronic International Standard Serial Number (EISSN)

  • 1885-5857

Digital Object Identifier (DOI)

  • 10.1016/j.rec.2017.02.021

Language

  • eng spa

Conference Location

  • Spain