Copyright © 2000 by the European Society of Cardiology.
Plasma semicarbazide-sensitive amine oxidase (SSAO) is an independent prognostic marker for mortality in chronic heart failure
a Department of Internal Medicine, Erasmus university Medical Centre Rotterdam, Rotterdam
b Cardiology, Thorax Centre, University Hospital Groningen, Groningen, The Netherlands
revised February 28, 2000; accepted March 1, 2000
Abstract
Aims Experimental evidence has suggested that semicarbazide-sensitive amine oxidase is involved in vascular endothelial damage and in the process of atherosclerosis, through the formation of reactive aldehydes, hydrogen peroxide and ammonia from endogenous substrates. Recent evidence indicates that semicarbazide-sensitive amine oxidase may be identical with the vascular adhesion protein-1. In patients with diabetes mellitus and chronic heart failure the plasma activity is raised relative to the severity of the disease. The prognostic value of plasma semicarbazide-sensitive amine oxidase is not known.
Methods and Results Plasma semicarbazide-sensitive amine oxidase activity was measured at baseline in patients with moderate to severe chronic heart failure who participated in a large European study (PRIME-II). The 372 patients who took part in a pre-defined substudy in The Netherlands were investigated and a survival follow-up (maximum 5·4 years, mean 3·4 years) was carried out. Within the follow-up period 195 patients died. Plasma semicarbazide-sensitive amine oxidase was higher at baseline in those who died than in the survivors (653±258 vs 540±242 mU.l1, P<0·001). Dividing the patients into two groups according to plasma values above or below the median value of 550mU.l1, semicarbazide-sensitive amine oxidase was found to be a prognostic parameter for survival, both in univariate (P<0·0001) and in multivariate (P=0·0106) analysis. Semicarbazide-sensitive amine oxidase values >550 mU.l1had a 1·50 (95% CI, 1·102·04) times increased risk of death.
Conclusion The finding that plasma semicarbazide-sensitive amine oxidase is an independent prognostic marker for mortality in chronic heart failure supports the concept that an elevated plasma semicarbazide-sensitive amine oxidase level has deleterious effects, possibly due to vascular endothelial damage.
Key Words: Semicarbazide-sensitive amine oxidase, heart failure, prognosis, endothelial dysfunction, adhesion protein
f1 Correspondence: Dr F. Boomsma, Dept. of Internal Medicine I, University Hospital Dijkzigt, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.
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