Predictive value of advanced glycation end products for the development of post-infarction heart failure: a preliminary report

Abstract

BackgroundSince post-infarction heart failure (HF) determines a great morbidity and mortality, and given the physiopathology implications of advanced glycation end products (AGE) in the genesis of myocardial dysfunction, it was intended to analyze the prognostic value of these molecules in order to predict post-infarction HF development.MethodsA prospective clinical study in patients after first acute coronary syndrome was conducted. The follow-up period was consisted in 1 year. In 194 patients consecutively admitted in the coronary unit for myocardial infarct fluorescent AGE levels were measured. The association between glycaemic parameters and the development of post-infarction HF were analyzed in those patients. Finally, we identified the variables with independent predictor value by performing a multivariate analysis of Hazard ratio for Cox regression.ResultsEleven out of 194 patients (5.6%) developed HF during follow-up (median: 1.0 years [0.8 - 1.5 years]). Even though basal glucose, fructosamine and glycated haemoglobin were significant predictive factors in the univariate analysis, after being adjusted by confounding variables and AGE they lost their statistical signification. Only AGE (Hazard Ratio 1.016, IC 95%: 1.006-1.026; p<0,001), together with NT-proBNP and the infarct extension were predictors for post-infarction HF development, where AGE levels over the median value 5-fold increased the risk of HF development during follow-up.ConclusionsAGE are an independent marker of post-infarction HF development risk.

Advanced glycation end products evoke endothelial cell damage by stimulating soluble dipeptidyl peptidase-4 production and its interaction with mannose 6-phosphate/insulin-like growth factor II receptor

“…Moreover, we have very recently found that DPP-4 inhibitor alogliptin treatment blocks the AGE-RAGE axis and resultantly reduces albuminuria in type 2 diabetes patients [47]. Fluorescent AGE levels have also been shown to be an independent marker of post-infarction heart failure development risk [48]. These data reinforce the important clinical implications of the present findings of linagliptin.…”

Association of subclinical myocardial injury with arterial stiffness in patients with type 2 diabetes mellitus

“…However, these tests are invasive in nature and therefore may not be clinically feasible to perform for research purpose. Moreover, whether advanced glycation end products, an intermediate product that is elevated in patients with T2DM and an independent marker of post-infarction heart failure, would contribute to elevation of hs-TnI would require evaluation by future studies [32]. …”

Damaging effects of hyperglycemia on cardiovascular function: spotlight on glucose metabolic pathways

“…It is also an inverse marker of left ventricular hypertrophy in patients with chronic kidney disease, therefore indicating that the RAGE pathway may be a causal risk factor for cardiac hypertrophy in this instance (174). In addition, plasma levels of sRAGE and N-carboxy-methyl(lysine) are increased with chronic heart failure (30), whereas AGE concentration is an independent marker of postinfarction heart failure development risk (245). sRAGE levels may also be useful for risk stratification in patients with heart failure (166).…”