In patients with non-ischemic dilated cardiomyopathy (NIDCM), high serum autotaxin (ATX) levels can be linked with increasing adverse clinical results.

• In this study of 104 patients with NIDCM (49.8 ± 13.4 years, 76 men), who were divided into two groups (high-ATX group and low-ATX group) using different cutoffs of median serum ATX levels for men and women, the prognostic impact of serum ATX was assessed.

• Median ATX levels for men and women were 203.5 ng/mL and 257.0 ng/mL, respectively.

• The high-ATX group had higher brain natriuretic peptide levels [224.0 pg/mL vs 96.5 pg/mL] than the low-ATX group.

• No significant differences in high-sensitivity C-reactive protein and collagen volume fraction levels in endomyocardial biopsy samples were found between the two groups.

• In the Kaplan–Meier survival analysis, significantly lower event-free survival rate was found in the high-ATX group vs low-ATX group.

• In Cox proportional hazard analysis, high-ATX was identified to be an independent determinant of composite cardiac events.

• In both genders, there was no correlation of serum ATX levels with high-sensitivity C-reactive protein levels and collagen volume fraction but a weak correlation was found with brain natriuretic peptide levels.