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. 2025 Feb;12(1):517-524.
doi: 10.1002/ehf2.15107. Epub 2024 Oct 3.

Catestatin as a predictor for cardiac death in heart failure with mildly reduced and preserved ejection fraction

Song-Yun Chu  1 , Fen Peng  1   2 , Jie Wang  1 , Lin Liu  1 , Jing Zhao  1 , Xiao-Ning Han  1 , Wen-Hui Ding  1
Affiliations

Catestatin as a predictor for cardiac death in heart failure with mildly reduced and preserved ejection fraction

Song-Yun Chu et al. ESC Heart Fail. 2025 Feb.

Abstract

Aims: Endogenous catecholamine release-inhibitory peptide catestatin has been associated with heart failure (HF). This subgroup analysis of our cohort of HF compared the different effects of catestatin as a predictor for cardiac outcomes in patients with HF with reduced (HFrEF), mildly reduced (HFmrEF) or preserved (HFpEF) ejection fraction.

Methods: Plasma catestatin was measured in the HF patient cohort of 228 cases with a whole spectrum of ejection fraction. The cardiac deaths were analysed according to prespecified subgroups.

Results: Over a median follow-up of 52.5 months, the association between plasma catestatin and cardiac death was different in patients with HFrEF, HFmrEF or HFpEF [hazard ratio (HR) 1.53, 95% confidence interval (CI) 0.99-2.37 and HR 2.73, 95% CI 1.56-4.75, respectively; interaction P = 0.022]. Patients with HFmrEF/HFpEF were older and more likely to be female, with non-ischaemic cardiomyopathy and atrial fibrillation but lower levels of plasma B-type natriuretic peptide (BNP). Similar adverse cardiac events occurred in patients with HFmrEF/HFpEF as in HFrEF. Plasma catestatin was a better predictor for cardiovascular death in the HFmrEF/HFpEF patients [area under the receiver operating characteristic curve (AUC) = 0.72, 95% CI 0.45-0.74] than in the HFrEF patients (AUC = 0.59, 95% CI 0.587-0.849). The optimal cut point of plasma catestatin level of 0.86 ng/mL predicted a 2.80-fold elevated risk for cardiac death in HFmrEF/HFpEF.

Conclusions: Elevated plasma catestatin might be a more sensitive predictor for cardiac outcome in patients with HFmrEF/HFpEF than in HFrEF.

Keywords: cardiac death; catestatin; heart failure with mildly reduced ejection fraction or preserved ejection fraction; predictor.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Plasma catestatin for prediction of cardiac death in prespecified subgroups. AF, atrial fibrillation; BNP, B‐type natriuretic peptide; CI, confidence interval; HF, heart failure; LVEF, left ventricular ejection fraction; PASP, pulmonary artery systolic pressure.
Figure 2
Figure 2
The receiver operating characteristic curves for plasma catestatin in predicting cardiovascular death in patients with heart failure with reduced ejection fraction (HFrEF) and heart failure with mildly reduced ejection fraction (HFmrEF)/heart failure with preserved ejection fraction (HFpEF).
Figure 3
Figure 3
The incidence of cardiovascular deaths assessed in a time‐to‐event analysis stratified by catestatin (CST) levels. Covariates adjusted were age, gender, New York Heart Association functional class, B‐type natriuretic peptide, pulmonary artery systolic pressure and estimated glomerular filtration rate. CI, confidence interval; HR, hazard ratio.
See this image and copyright information in PMC

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