Abstract
OBJECTIVES: This study aimed to measure the level of phenylacetylglutamine (PAGln) and its correlation with anaemia in ischaemic heart failure (HF) patients. DESIGN: A prospective cohort study. SETTING: The study was conducted at Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. PARTICIPANTS: A total of 89 ischaemic heart failure (IHD) patients confirmed by symptoms, echocardiography and coronary angiography and 75 healthy controls were enrolled (all aged≥18 years). PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was the association between serum PAGln levels and low haemoglobin (HGB). The secondary outcome was to explore the composite endpoint of cardiovascular death and HF hospitalisations during 1 year of follow-up. RESULTS: The PAGln levels were significantly higher in IHD patients compared with the control population (716 (440-1097) vs 411 (202-697) ng/mL, p<0.001). There were 27 IHD patients who had low HGB (27/89). In HF patients with IHD, after adjustment for age and log N-terminal brain natriuretic peptide (NT-proBNP), the tertiles of PAGln were associated with low HGB (OR, 2.610; 95% CI: 1.251 to 5.447; p=0.011). Moreover, during the 1 year follow-up, PAGln levels continued to demonstrate the relationship with HF endpoints (19/73, 26.0%) (HR=3.547, 95% CI: 1.254 to 10.034, p=0.017), even after adjusting for HGB and log NT-proBNP in Cox regression analysis. CONCLUSIONS: In HF patients with IHD, the elevated PAGln levels were related to reduced HGB. Additionally, the increased PAGln concentrations with low HGB were linked to poor HF endpoint events.