Heat shock protein 27 acts as a predictor of prognosis in chronic heart failure patients.

Heat shock proteins (HSPs) represent intracellular mechanisms of stress response. Clinical implications of their (systemic) expression in patients with chronic heart failure (HF) remain inconclusive. In outpatients with chronic stable HF plasma HSP27 levels were measured using ELISA. Patients were followed for a minimum of one year, and a multivariate Cox proportional hazard model was built for cardiovascular death or HF-associated hospitalisations. A total of 134 patients with chronic HF (mean age 71±10years, 34% female, mean LVEF 36±12%) were included. During a mean follow-up of 527±260days, 44 patients (33%) experienced an event. Mean time to event was 350±236days. In a Kaplan-Meier survival analysis HSP27 levels above the median (3820pg/ml) indicate a higher risk for an event (p=0.03). Increased HSP27 levels remained an independent predictor of events (HR, 2.33 CI 95% 1.12-4.87, p=0.024) even after adjustment for age, gender, NT-proBNP, LVEF, aetiology, smoking status, kidney function and NYHA class. HSP27 is an independent predictor of prognosis in chronic HF. Our findings suggest that HSP27 may improve risk-stratification in chronic HF beyond known prognostic predictors.