Phenylacetylglutamine as a risk factor and prognostic indicator of heart failure

Aims To explore the associations between serum phenylacetylglutamine (PAGIn) and chronic heart failure (HF). Methods and results Totally 956 subjects were enrolled consecutively from the Department of Cardiovascular Medicine, Ruijin Hospital. Baseline data were obtained from all participants, and 471 stable chronic HF subjects were followed up. Serum PAGIn was analysed by liquid chromatography-tandem mass spectrometry. The association between PAGIn and basic renal indicators was assessed by simple correlation analysis. Logistic regression analysis was conducted to measure the association between PAGIn and HF risk. Event-free survival was determined by Kaplan-Meier curves, and differences in survival were assessed using log-rank tests. Cox proportional hazards analysis was used to assess the prognostic value of PAGIn in HF. Serum PAGIn levels were increased in patients with chronic HF (3.322 +/- 8.220 mu M vs. 1.249 +/- 1.168 mu M, P < 0.001) and were associated with HF after full adjustment [odds ratio (OR), 1.507; 95% confidence interval (CI): 1.213-1.873; P < 0.001]. PAGIn levels were correlated with the levels of basic renal indicators. High PAGIn levels indicated a high risk of renal dysfunction in HF (OR: 1.853; 95% CI: 1.344-2.556; P < 0.001), and elevated PAGIn levels were associated with a high risk of cardiovascular death in patients with chronic HF (HR: 2.049; 95% CI: 1.042-4.029; P = 0.038). Conclusions Elevated PAGIn levels are an independent risk factor for HF and are associated with a higher risk of cardiovascular death. High PAGIn levels could indicate renal dysfunction in HF patients. PAGIn can be a valuable indicator of HF.