The association between serum selenium concentration and prognosis in patients with heart failure in a Chinese population

Abstract

Whether Selenium (Se) deficiency relates with adverse prognosis in Chinese patients with heart failure (HF) is still unknown. This study aimed to investigate the association of serum Se level and the outcomes of patients with HF in a Chinese population. Patients with HF and serum Se examination were retrospectively included. Baseline information were collected at patient’s first admission. The primary and secondary outcomes were all-cause mortality and rehospitalization for HF during follow-up, respectively. The study participants were divided into quartiles according to their serum Se concentrations. The Cox proportional hazard models were adopted to estimate the association of serum Se levels with observed outcomes. A total of 411 patients with HF with a mean age of 62.5 years were included. The mean serum level of Se was 68.3 ± 27.7 µg/L. There was nonsignificant difference of baseline characterizes between the four quartile groups. In comparison with patients in the highest quartile, those with the lowest quartile (17.40–44.35 µg/L) were associated with increased risk of all-cause mortality [adjusted hazard ratios (95% CI) 2.32 (1.43–3.77); Ptrend = 0.001]. Our study suggested that a lower serum Se level was significantly associated with increased risk of all-cause mortality in patients with HF.

The Impact of Selenium Deficiency on Cardiovascular Function

“…Since the discovery of Se involvement in Keshan’s Disease more than fifty years ago [ 2 , 23 , 93 ], the knowledge of the involvement of Se in cardiovascular diseases has expanded significantly. Se is now known to participate in a host of different cardiovascular disorders, including myocardial infarction, heart failure, cardiomyopathies, atherosclerosis, and coronary heart disease, as Se deficiency is associated with increased risk of these cardiovascular diseases [ 4 , 5 , 30 , 99 , 117 ]. Therefore, it is unsurprising that Se supplementation has been explored as a potential therapeutic to treat several of these cardiovascular disorders when they are linked to a deficient intake status for Se.…”

“…Se deficiency also is associated with heart failure [ 4 , 29 , 30 , 31 ]. Serum Se concentrations measured in a large European cohort of patients with worsening heart failure were low in 70% of these patients.…”

Selenium, TGF-Beta and Infectious Endemic Cardiopathy: Lessons from Benchwork to Clinical Application in Chagas Disease

“…Fifteen years ago, in our first Se study with CD patients [23] 96% of the participants showed Se levels < 100 mcg/L and 52% < 70 mcg/L. In a Chinese populational study including 411 patients with heart failure [53], the mean serum level of Se was of 68.3 ± 27.7 mcg/L. This study showed that lower serum Se level was significantly associated with increased risk of all-cause mortality in patients with heart failure, comparing patients in the highest quartile of Se levels (94.15-116.7 ng/mL), to those with lowest quartile (17.40-44.35…”

“…A direct correlation between serum Se levels and progression of heart disfunction, especially heart failure, is still under debate [14][15][16][17][52][53][54]. STCC also showed scattered basal levels of Se ranged from 40 to 150 ng/mL, a variability that deserves further studies for a clearest picture related to selenoprotein genetic polymorphisms and/or regional diets varying in Se content.…”

“…A level of evidence graded B could be proposed for Se treatment in CD patients if we consider that the recommendation of Se administration from 100 to 200 mcg/day from 6 months to 5 years to 18 to 88 year-old adults [12,13,19,[61][62][63][64][65] is safe. However, a direct beneficial effect of Se treatment in CVD was not definitively proven, and we need to revisit some of the recently sorted reviews (Table S1 in supplementary material) indicating the plausibility of using Se treatments for CVD and CD [14][15][16][17][18][51][52][53].…”