Evaluation value of serum TIMP-1 combined with ultrasound index of heart failure in the long-term prognosis of diabetic patients with heart failure

Liu Zuoling; Xu Jinrong; Fang Lingyan

doi:10.3969/j.issn.1674-4055.2024.09.13

Abstract：Objective To assess the prognostic value of serum tissue inhibitor of metalloproteinase 1(TIMP-1)in conjunction with heart failure ultrasound indices for long-term outcomes in patients with diabetes mellitus complicated with heart failure.Methods From May 2019 to May 2020,150 patients with diabetes mellitus complicated by heart failurewere admitted to our hospital and selected for the study group.These patients werebased on the occurrence of major adverse cardiovascular events(MACE)during a three-year follow-up into a non-MACE group(n=85)and a MACE group(n=65).Additionally,96 individuals from a concurrent health screening cohort served as the control group.Upon admission,serum TIMP-1 level was measured using enzyme-linked immunosorbent assay(ELISA),and echocardiograms were performed to evaluate the ultrasound indices of heart failure.The general and biochemical data of each group were analyzed and compared.The prognostic value of combining serum TIMP-1 levels with heart failure ultrasound indices for predicting long-term outcomes in patients with diabetes mellitus and heart failure was assessed using ROC curves.Multivariate Cox regression was utilized to identify factors influencing long-term prognosis in these patients.Results The ultrasound indices of heart failure were significantly higher in the study group than in the control group,while serum TIMP-1 levels were lower(P＜0.05).In the MACE group,the ultrasound indices of heart failure were higher and serum TIMP-1 levels were lower compared to the non-MACE group(P＜0.05).ROC curve analysis revealed that the AUC for evaluating long-term prognosis in patients with diabetes mellitus complicated by heart failure were 0.812(95％CI:0.762～0.772)for serum TIMP-1 and 0.827(95％CI:0.777～0.887)for the ultrasound index of heart failure.The combined AUC for serum TIMP-1 and the ultrasound index of heart failure was 0.909(95％CI:0.879～0.939).Multivariate Cox regression analysis indicated thatNT-proBNP(HR=3.387,95％CI:1.863～6.158),HbAlc(HR=2.713,95％CI:1.552～4.743),LVEF(HR=3.904,95％CI:2.037～7.484),TIMP-1(HR=4.397,95％CI:2.142～9.028)and ultrasound index of heart failure(HR=3.550,95％CI:1.867～6.752)were significant predictors of long-term prognosis in patients with diabetes mellitus complicated by heart failure(P＜0.05).Conclusion In patients with diabetes mellitus complicated by heart failure,decreased serum TIMP-1 levels and increased ultrasound indices of heart failure were closely associated with long-term prognosis.The combination of these two factors provides a superior predictive value for assessing long-term outcomes.