- Participants in a set of 4 cohorts show different biomarker profiles associated with heart failure (HF) with reduced or preserved ejection fraction (HFrEF, HFpEF, respectively).
- The usual natriuretic peptides (NPs) and urinary albumin-creatinine ratio (UACR) characterized HFpEF, whereas HFrEF was also associated with high-sensitivity troponin, inflammation, and neurohormonal activation.
- Adding biomarkers improved risk estimates somewhat and discriminated HFrEF a little better than HFpEF.
Why this matters
- Despite the existence of at least 2 HF subtypes, biomarker profiles that distinguish them remain to be established.
- These authors say the results point to the need for more focus on biomarker studies, especially for HFpEF.
- Study evaluated 22,756 participants from 4 longitudinal community-based cohorts.
- Funding: National Heart, Lung, and Blood Institute.
- UACR (subdistribution aHR [saHR], 1.33; P<.001) and NPs (saHR, 1.27; P<.001) were associated with HFpEF risk.
- NP (saHR, 1.54; P<.001), UACR (saHR, 1.21; P<.001), high-sensitivity troponin (saHR, 1.37; P<.001), cystatin C (saHR, 1.19; P<.001), D-dimer (saHR, 1.22; P<.001), and C-reactive protein (saHR, 1.19; P<.001) were associated with HFrEF.
- C-statistic for HFrEF improved with addition of NP (+0.022; P<.001) and high-sensitivity troponin (+0.021; P<.001).
- For HFpEF, improvement was smaller, with the largest for UACR (+0.010; P=.03).
- Not all biomarkers were available in each cohort.
Coauthored with Antara Ghosh, PhD