DPP3 was measured in 2156 serum samples of patients with worsening heart failure using luminometric immunoassay (DPP3-LIA) by 4TEEN4 Pharmaceuticals GmbH, Hennigsdorf, Germany. Predictors of DPP3 levels were selected using multiple linear regression with stepwise backward selection.
Median DPP3 concentration was 11.45 ng/mL with a range from 2.8 to 84.9 ng/mL. Patients with higher DPP3 concentrations had higher renin (78.3 (IQR 26.3, 227.7) vs 120.7 UI/mL (IQR 34.74, 338.9), p < 0.001, for Q1-3 vs Q4) and aldosterone (88 (IQR 44, 179) vs 116 UI/mL (IQR 46, 241), p < 0.001, for Q1-3 vs Q4) concentrations. The strongest independent predictors for higher concentration of DPP3 were log ALT, log-total bilirubin, the absence of diabetes, higher osteopontin FGF-23 and NT pro BNP concentrations (all p < 0.001). In univariable survival analysis DPP-3 was associated with mortality and the combined endpoint of death or HF hospitalization (P < 0.001 for both). After adjustment for confounders this association was no longer significant.
In patients with worsening heart failure DPP3 is a marker of more severe disease with higher RAAS activity. It may be deleterious in HF by counteracting the Mas-receptor pathway. Procizumab, a specific antibody against DPP3 might be a potential future treatment option for patients with heart failure.
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