Neopterin as a novel marker; well correlated with mortality and morbidity in patients with advanced systolic heart failure

Acta Cardiol. 2019 Jun;74(3):216-221. doi: 10.1080/00015385.2018.1478266. Epub 2018 Jun 18.

Abstract

Objective: The aim of this study is research relation of serum neopterin level with mortality and morbidity due to systolic HF and also its role in diagnosis of patients with systolic HF. Material and methods: Eighty-one patients with systolic heart failure (HF group) and eighty-one age- and gender-matched healthy subjects (the control group) were enrolled in the study. Echocardiographic examination was performed accordingly. At the beginning of the study, serum B type natriuretic peptide (BNP), neopterin, and high sensitive C-reactive protein (hs-CRP) were measured accordingly. The subjects were followed for one year then after. Mortality rate and number of hospitalisation due to HF were recorded. Results: Age and gender distribution over the groups were statistically similar (p > .05). LVEF of the control and HF groups were 62 ± 3 and 27 ± 3%, respectively (p < .001). Average neopterin value of HF group was significantly higher than that of the control group (p < .001). Both hs-CRP and BNP values were well correlated to neopterin values (p = .667 and .778, respectively). There was a significant correlation between number of hospitalisation and neopterin values among patients in HF group (p = .008). Also among HF group, neopterin value of patients died within first year of follow-up (n = 29) was higher than that of patients survived beyond first year (n = 52 and p = .011). Conclusions: Neopterin is a biomarker reflecting ongoing inflammatory process in deteriorating heart. High level of serum neopterin concentrations was associated with mortality and morbidity in systolic HF.

Keywords: B type natriuretic peptide; Neopterin; heart failure; morbidity; mortality.

MeSH terms

  • Aged
  • Biomarkers / blood
  • C-Reactive Protein / metabolism
  • Case-Control Studies
  • Disease Progression
  • Female
  • Heart Failure, Systolic / blood*
  • Heart Failure, Systolic / diagnosis
  • Heart Failure, Systolic / mortality
  • Heart Failure, Systolic / physiopathology
  • Humans
  • Inflammation Mediators / blood*
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain / blood
  • Neopterin / blood*
  • Patient Admission
  • Predictive Value of Tests
  • Prognosis
  • Prospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Up-Regulation
  • Ventricular Function, Left

Substances

  • Biomarkers
  • Inflammation Mediators
  • Natriuretic Peptide, Brain
  • Neopterin
  • C-Reactive Protein