Orosomucoid as prognosis factor associated with inflammation in acute or nutritional status in chronic heart failure

Background: Inflammation and nutritional state are involved in the pathogenesis of heart failure (HF). Objective: To study the contribution of alpha-1-acid-glycoprotein (AGP) to these factors and its prognostic value in acute (AHF) or chronic HF (CHF). Methods: The observational study has included 147 patients (mean age 70 years, 62% men) admitted to a cardiology department for HF and followed-up for an average 326.6 +/- 140.8 days. Blood AGP values were measured by Enzyme-Linked ImmunoSorbent Assay. Monocytes subsetswere determinedwith CD14 and CD16 antibodies by flowcytometry and body composition was measured by dual-energy X-ray absorptiometry. The regulation of tumor necrosis factor (TNF-alpha) and leptin by AGP in epicardial adipose tissue (EAT) were analyzed by real time polymerase chain reaction. Results: High AGP, that was associated with CD14(+) CD16(+) monocytes, and proBNP levels at the discharge were indicators of rehospitalization for HF in AHF patients. However, low AGP levels determined a worse nutritional state in CHF patients. The leptin levels were downregulated by high AGP concentration in epicardial fat. Conclusion: AGP is a dual indicator in HF because high levels are predictors of adverse outcomes in AHF but low levels are related to the worse nutritional status in CHF. The regulation of leptin by AGP in epicardial fat might suggest a new pathway as protective mechanism in CHF. (C) 2016 Elsevier Ireland Ltd. All rights reserved.