Knowledge of the role of the soluble receptor for advanced glycation end products (sRAGEs) in chronic heart failure (CHF) is very limited. In the present study, we measured plasma sRAGE levels in patients with CHF and examined whether plasma sRAGE predicts prognosis in patients with HF independently of validated scores as the Seattle Heart Failure Score (SHFS). We measured plasma sRAGE in 106 outpatients with CHF. Patients were prospectively followed during a median follow-up period of 1.3 years with end points of cardiac death or rehospitalization. Plasma sRAGE level increased with advancing New York Heart Association functional class, SHFS, age, and ischemic cause. Plasma sRAGE level was also higher in patients with cardiac death and/or events than in event-free patients. In Cox multivariate proportional hazard analysis, SHFS, sRAGE, and N-terminal pro-B-type natriuretic peptide were independent risk factors for cardiac death (sRAGE hazard ratio 1.26, 95% confidence interval 1.09 to 1.45, p = 0.002) and/or cardiac events (sRAGE hazard ratio 1.07, 95% confidence interval 1.03 to 1.11, p = 0.002). Survival curves adjusted by Cox analysis clearly demonstrated that the high-sRAGE group (higher than median) had a significantly higher incidence of cardiac death than the low-sRAGE group (p = 0.001). In conclusion, sRAGE is a novel, highly sensitive, and specific prognostic marker in current optimally treated patients with CHF with an additive and independent value compared to the multimarker SHFS.
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