Fetuin-A and sodium concentrations are independently associated with all-cause mortality in patients awaiting heart transplantation

INTRODUCTION End-stage heart failure (HF) is a clinical condition with complex pathophysiology and poor prognosis. OBJECTIVES This study aimed to identify factors associated with mortality during a 1.5-year follow-up in patients with end-stage HE. PATIENTS AND METHODS We prospectively analyzed 72 patients hospitalized with end-stage HF During right heart catheterization, 10 ml of coronary sinus (CS) blood was collected. The endpoint was all-cause mortality during a 1.5-year follow-up. We used a multivariable logistic regression model to find factors associated with all-cause mortality. We created 2 separate models for CS fetuin and peripheral blood (PB) fetuin. RESULTS The median (interquartile range) age of the patients was 58 (50-61.50) years. During the follow-up, 43.1% of the patients died. Lower levels of fetuin-A in the CS (OR, 1.103; 95% CI, 1.045-1.164; P <0.001, per 10-unit decrease in fetuin concentration) and PB samples (OR, 1.098; 95% CI, 1.046-1.153; P <0.001, per 10-unit decrease in fetuin concentration), along with lower plasma sodium levels (OR, 1.563; 95% CI, 1.134-2.156; P = 0.006 in the first model and OR, 1.639; 95% CI, 1.209-2.227; P = 0.002 in the second model; per 1-unit decrease in sodium concentration) were independently associated with death during the follow-up period. The area under the receiver operating characteristics curve (AUC) indicated a good prognostic power of CS and PB fetuin-A levels (AUC, 0.917 and AUC, 0.850, respectively) and an acceptable prognostic power of sodium concentration (AUC, 0.788). CONCLUSION Lower levels of CS and PB fetuin-A, as well as lower sodium levels, are associated with an increased risk of death in patients with end-stage HF.