Circulating monocyte subsets and heart failure prognosis

PLoS One. 2018 Sep 21;13(9):e0204074. doi: 10.1371/journal.pone.0204074. eCollection 2018.

Abstract

Monocytes are a heterogeneous population of effector cells with key roles in tissue integrity restoration and maintenance. Here, we explore the association of monocyte subsets and prognosis in patients with ambulatory heart failure (HF). Monocyte subsets were classified as classical (CD14++/CD16-), intermediate (CD14++/CD16+), or non-classical (CD14+/CD16++). Percentage distribution and absolute cell count were assessed in each subset, and multivariable Cox regression analyses were performed with all-cause death, HF-related hospitalization, and the composite end-point of both as dependent variables. 400 patients were consecutively included (72.8% male, age 69.4±12.2 years, 45.5% from ischemic aetiology, left ventricle ejection fraction (LVEF) 41.6% ±14.5, New York Heart Association (NYHA) class II 62.8% and III 30.8%). During a mean follow-up of 2.6±0.9 years, 107 patients died, 99 had a HF-related hospitalization and 160 suffered the composite end-point of all-cause death or HF-related hospitalization. Monocyte subsets assessed in percentages were not independently associated to any of the end-points. When considering number of cells/μL, intermediate subset was independently associated with an increase of all-cause death (HR 1.25 [95% CI 1,02-1.52], p = 0.03), and the composite end-point HR 1.20 [95% CI 1,03-1.40], p = 0.02). The presented findings show that absolute cell count of monocyte subsets was preferred over monocyte percentage for prognosis stratification for outpatients with HF. The intermediate monocyte subset provides information on increased risk of all-cause death and the composite end-point.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cause of Death
  • Cell Movement*
  • Disease-Free Survival
  • Female
  • Heart Failure / blood
  • Heart Failure / diagnosis*
  • Heart Failure / pathology*
  • Humans
  • Male
  • Monocytes / pathology*
  • Prognosis
  • Proportional Hazards Models
  • Risk Factors

Grants and funding

This work was supported by grants from the Ministerio de Economía, Industria y Competitividad (SAF2017-84324-C2-1-R to ABG), Fundació La MARATÓ de TV3 (201502 to ABG, 201516), CIBER Cardiovascular (CB16/11/00403 to ABG), Red de Terapia Celular—TerCel (RD16/0011/0006 to ABG), AdvanceCat with the support of ACCIÓ [Catalonia Trade & Investment; Generalitat de Catalunya] under the Catalonian ERDF [European Regional Development Fund] operational program (2014-2020), the Fundació Bancària La Caixa, and Fondo de Investigación Sanitaria, Instituto de Salud Carlos III (FIS PI17/01487 to JL) as part of the Plan Nacional de I+D+I cofounded by ISCIII-Sudirección General de Evaluación y el Fondo Europeo de Desarrollo Regional (FEDER). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.