Secretoneurin: strong association with mortality in patients with Implantable Cardioverter Defibrillator

R. Allgaier (Regensburg)¹, C. Strack (Regensburg)¹, S. Wallner (Regensburg)², U. Hubauer (Regensburg)¹, E. Ücer (Regensburg)¹, P. Lehn (Regensburg)², A. Luchner (Regensburg)³, L. S. Maier (Regensburg)¹, C. G. Jungbauer (Regensburg)^1
1Universitätsklinikum Regensburg Klinik und Poliklinik für Innere Med. II, Kardiologie Regensburg, Deutschland; ²Universitätsklinikum Regensburg Institut für Klinische Chemie und Laboratoriumsmedizin Regensburg, Deutschland; ³Krankenhaus Barmherzige Brüder Regensburg Klinik für Kardiologie Regensburg, Deutschland

Background and objectives:
Chronic heart failure represents a global health problem. Previous studies suggest Secretoneurin as biomarker with prognostic impact in patients with cardiovascular diseases and heart failure. Aim of the study was to assess the prognostic value of Secretoneurin in a mixed cohort of patients with chronic heart failure and Implantable Cardioverter Defibrillator (ICD).
Methods:
412 patients with an ICD were included in the study. On admission, blood samples were obtained to assess Secretoneurin and follow-up was performed after 45 months. Data regarding all-cause mortality were obtained by death registries, attending physicians and telephone interviews. In multivariate Cox regression analysis we included Diabetes, primary prevention ICD indication, coronary artery disease, eGFR, left ventricular ejection fraction and age.
Results:
Secretoneurin was positively correlated with NT-proBNP (r = .52), age (r = .44) and serum creatinine (r = .65; each p < .001). Secretoneurin as well as NT-proBNP were significantly elevated in patients with left ventricular ejection fraction ≤ 40% compared to patients with left ventricular ejection fraction > 40% and significantly elevated in patients suffering from chronic kidney disease compared to patients without chronic kidney disease (each p < .001). Further, secretoneurin and NT-proBNP were significantly elevated in deceased patients (p < .001).  According to Kaplan Meier analysis, Secretoneurin ≥ median as well as NT-proBNP ≥ median were significant predictors for all-cause mortality (p < .001). In multivariate Cox regression analysis Secretoneurin and left ventricular ejection fraction as well as NT-proBNP and eGFR represented independent predictors for all-cause mortality (each p < .05).
Conclusion:
Secretoneurin shows prognostic value in patients with chronic heart failure and ICD. This study shows a strong association between Secretoneurin and all-cause mortality comparable to NT-proBNP.