HE4 Serum Levels are Associated with Poor Prognosis in Patients with Acute Heart Failure Combined with Chronic Kidney Disease

Yi Tang; Zhengqi Hu; Zhibin Liu; Siling Peng; Tiancheng Liu; Yaoyuan Xiao; Jianqiang Peng; Hongwei Pan; Zhaofen Zheng; Jin He

doi:10.2147/IJGM.S444680

HE4 Serum Levels are Associated with Poor Prognosis in Patients with Acute Heart Failure Combined with Chronic Kidney Disease

Int J Gen Med. 2024 Apr 2:17:1273-1280. doi: 10.2147/IJGM.S444680. eCollection 2024.

Authors

Yi Tang^#¹, Zhengqi Hu^#², Zhibin Liu², Siling Peng², Tiancheng Liu², Yaoyuan Xiao², Jianqiang Peng¹, Hongwei Pan¹, Zhaofen Zheng¹, Jin He¹

Affiliations

¹ Department of Cardiology, Hunan Provincial People's Hospital, the First Affiliated Hospital of Hunan Normal University, Clinical Medicine Research Center of Heart Failure of Hunan Province, Hunan Normal University, Changsha, People's Republic of China.
² Department of Cardiology, Hunan Provincial People's Hospital, the First Affiliated Hospital of Hunan Normal University, Changsha, People's Republic of China.

^# Contributed equally.

Abstract

Purpose: The levels of human epididymis protein 4 (HE4) is associated not only with the prognosis of patients with acute heart failure (AHF), but also with chronic kidney disease (CKD). Our study aims to understand the prediction value of HE4 on prognosis in patients with AHF combined with CKD.

Patients and methods: This study prospectively enrolled patients diagnosed with AHF combined with CKD at the Department of Cardiology of Hunan Provincial People's Hospital from March 2019 to December 2022. Serum levels of HE4 were measured using a chemiluminescence microparticle immunoassay. The endpoint events included heart failure readmission and cardiovascular death.

Results: A total of 130 patients with AHF combined with CKD were included in the stud. The median age is 73 years (interquartile range: 65-79 years). Among the patients, 94 experienced the endpoint events. The multivariable Cox analysis reveals that LnHE4 (HR=2.280, 95% CI 1.300-3.998, P = 0.004) and age (HR=1.024, 95% CI 1.003-1.045, P = 0.025) are independent predictors of the endpoint events. The Kaplan-Meier survival curve demonstrates that patients with HE4 levels>276.15 pmol/L has a significantly higher incidence of endpoint events compared to those with HE4 levels≤276.15 pmol/L (Log rank test: χ2=19.689, P < 0.001). After adjusting for age and gender, the HR is 2.520 (95% CI: 1.626-3.906, P < 0.001).

Conclusion: HE4 is an independent predictor of heart failure readmission and cardiovascular death in patients with AHF combined with CKD.

Keywords: Acute heart failure; Chronic kidney disease; Human epididymis protein 4; Prognosis.

Grants and funding

This work was supported by grants from the Science and Technology Innovation Program of Hunan Province (2020SK50923), the Research Project of Hunan Provincial Health Commission (202103012371), Renshu Fund Project of Hunan Provincial People’s Hospital (RS2022A12).