Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Heart Failure
Urinary 8-Hydroxy-2'-Deoxyguanosine as a Novel Biomarker for Predicting Cardiac Events and Evaluating the Effectiveness of Carvedilol Treatment in Patients With Chronic Systolic Heart Failure
Takehisa SusaShigeki KobayashiTakeo TanakaWakako MurakamiShintaro AkashiIchiro KunitsuguShinichi OkudaMasahiro DoiYasuaki WadaTomoko NaoJutaro YamadaTakeshi UeyamaTakayuki OkamuraMasafumi YanoMasunori Matsuzaki
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2012 Volume 76 Issue 1 Pages 117-126

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Abstract
Background: The authors recently reported that urinary 8-hydroxy-2'-deoxyguanosine (U8-OHdG) derived from cardiac tissue reflects clinical status and cardiac dysfunction severity in patients with chronic heart failure (CHF). The aim of the present study was to investigate whether U8-OHdG levels can accurately predict cardiac events in CHF patients and their response to β-blocker treatment. Methods and Results: Plasma brain natriuretic peptide (BNP) and U8-OHdG levels were measured in 186 consecutive CHF patients before discharge. Patients were then prospectively followed (median follow-up, 649 days) with endpoints of cardiac death or hospitalization due to progressive heart failure. From receiver operating characteristic curve analysis, cut-offs were 12.4ng/mg creatinine (Cr) for U8-OHdG and 207pg/ml for BNP. On multivariate Cox analysis, U8-OHdG and BNP were independent predictors of cardiac events. Patients were classified into 4 groups according to U8-OHdG and BNP cut-offs. The hazard ratio for cardiac events in patients with BNP ≥207pg/ml and U8-OHdG ≥12.4ng/mg Cr was 16.2 compared with approximately 4 for patients with only 1 indicator above its respective cut-off. Furthermore, carvedilol therapy was initiated in 30 CHF patients. In responders (≥10% increase in left ventricular ejection fraction [LVEF] or ≥1 class decrease in New York Heart Association [NYHA] class), U8-OHdG levels decreased significantly along with improved NYHA class, LVEF, and BNP levels after treatment. Conclusions: U8-OHdG may be a useful biomarker for predicting cardiac events and evaluating β-blocker therapy effectiveness in CHF patients. (Circ J 2012; 76: 117-126)
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© 2012 THE JAPANESE CIRCULATION SOCIETY
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