Circulating Osteonectin as a Predictive Biomarker in Patients with Ischemic Symptomatic Chronic Heart Failure

Background: Recently, some studies have revealed Osteonectin’s (OSN) promising role as a marker in cardiovascular diseases. Objectives: This study aimed to evaluate the prognostic value of circulating OSN for cumulative survival and hospitalization in patients with ischemic Chronic Heart Failure (CHF). Patients and Methods: This open cohort prospective study was conducted on 154 patients with ischemic symptomatic moderate-to-severe CHF at discharge from hospital. The observation period was up to 3 years (156 weeks). Blood samples for biomarker measurements were collected at baseline. ELISA method was used for measurement of OSN circulating level. Then, Receiver Operating Characteristic (ROC) curve analysis was carried out to identify the optimal cut-off points of the OSN concentration with predicted values. Odds ratios were also calculated for all the independent predictors of patients’ survival. Kaplan-Meier survival curves were also structured for both cohorts with low and high OSN levels. Results: During a median follow-up of 2.18 years, 21 participants died and 106 subjects were hospitalized repetitively. The median of circulating OSN levels were 670.96 ng/mL (95% Confidence Interval [CI] = 636.53 - 705.35 ng/mL) and 907.84 ng/mL (95% CI = 878.02 - 937.60 ng/mL) in the survived and dead patients cohorts, respectively. Besides, ROC curve analysis showed that optimal cut-off point of OSN for cumulative survival function was 845.15 ng/mL. The results also revealed significant divergence of KaplanMeier survival curves in the patients with high (> 845.15 ng/mL) and low (< 845.15 ng/ mL) concentrations of OSN. Conclusions: Increased circulating OSN levels were associated with increased 3-year CHF-related death, all-cause mortality, and risk of recurrent hospitalization due to CHF.