The prognostic value of secreted frizzled-related protein 2 in elderly patients with heart failure: a single-center retrospective study

This study was conducted to assess the prognostic value of secreted frizzled-related protein 2 (SFRP2) for mortality and readmission in elderly patients with acute exacerbation of chronic heart failure (HF). Elderly patients hospitalized for worsening chronic HF were enrolled in the present study. We detected the concentration of serum SFRP2 in these patients. The primary endpoint of this study was defined as all-cause mortality and the secondary endpoint was a composite of all-cause mortality and readmission due to HF, acute myocardial infarction, and malignant arrhythmia during a median follow-up period of 450 (interquartile range 224-942) days. Multivariable Cox proportional hazard models were performed to evaluate the prognostic value of SFRP2. Of 161 patients at baseline, we observed 72 events (25 deaths and 47 readmissions). Serum SFRP2 levels were significantly elevated in elderly HF patients with events relative to those without and control subjects (all P < 0.001). The Kaplan-Meier analysis showed a significantly increased risk of all-cause mortality and cardiovascular readmissions stratified by the optimal cut-off value of serum SFRP2 level (log-rank P < 0.005). An elevated SFRP2 level and N-terminal pro-B-type natriuretic peptide (NT-proBNP) level was independently and significantly associated with the primary endpoint and secondary endpoint (adjusted hazard ratio [HR] 2.334, 95% confidence interval [CI] 1.059-5.147;P = 0.036 and HR 2.326, 95% CI 1.426-3.794;P = 0.001, respectively) in multivariable Cox regression analysis. A higher level of serum SFRP2 can be considered as an independent predictor of poorer clinical outcomes for elderly patients with acute exacerbation of chronic heart failure, indicating that evaluation of SFRP2 could provide more useful information for the long-term prognosis in these patients beyond NT-proBNP.