PLoS ONE (Jan 2021)

Serum syndecan-1 concentration in hospitalized patients with heart failure may predict readmission-free survival

  • Yuichiro Kitagawa,
  • Itta Kawamura,
  • Keiko Suzuki,
  • Hideshi Okada,
  • Takuma Ishihara,
  • Hiroyuki Tomita,
  • Kodai Suzuki,
  • Chihiro Takada,
  • So Sampei,
  • Soichiro Kano,
  • Kohei Kondo,
  • Hirotaka Asano,
  • Yugo Wakayama,
  • Ryo Kamidani,
  • Yuki Kawasaki,
  • Hirotsugu Fukuda,
  • Ayane Nishio,
  • Takahito Miyake,
  • Tetsuya Fukuta,
  • Ryu Yasuda,
  • Hideaki Oiwa,
  • Yoshinori Kakino,
  • Nagisa Miyazaki,
  • Takatomo Watanabe,
  • Takahiro Yoshida,
  • Tomoaki Doi,
  • Akio Suzuki,
  • Shozo Yoshida,
  • Hitoshi Matsuo,
  • Shinji Ogura

Journal volume & issue
Vol. 16, no. 12

Abstract

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Syndecan-1 is found in the endothelial glycocalyx and is released into the bloodstream during stressed conditions, including severe diseases such as acute kidney injury, chronic kidney disease, and cardiovascular disease. This study investigated the prognostic value of serum syndecan-1 concentration in patients with heart failure upon admission. Serum syndecan-1 concentration was analyzed in 152 patients who were hospitalized for worsening heart failure from September 2017 to June 2018. The primary outcome of the study was readmission-free survival, defined as the time from the first admission to readmission for worsened heart failure or death from any cause, which was assessed at 30 months after discharge from the hospital. The secondary outcome of the study was survival time. Blood samples and echocardiogram data were analyzed. Univariate and multivariable time-dependent Cox regression analyses adjusted for age, creatinine levels, and use of antibiotics were conducted. The serum syndecan-1 concentration was significantly associated with readmission-free survival. Subsequently, the syndecan-1 concentration may have gradually decreased with treatment. The administration of human atrial natriuretic peptide and antibiotics may have modified the relationship between readmission-free survival and serum syndecan-1 concentration (p = 0.01 and 0.008, respectively). Serum syndecan-1 concentrations, which may indicate injury to the endothelial glycocalyx, predict readmission-free survival in patients with heart failure.