Biomarkers distinguish HFrEF and HFpEF

Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • 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 design

  • Study evaluated 22,756 participants from 4 longitudinal community-based cohorts.
  • Funding: National Heart, Lung, and Blood Institute.

Key results

  • UACR (subdistribution aHR [saHR], 1.33; P<.001 and nps p were associated with hfpef risk.>
  • NP (saHR, 1.54; P<.001 uacr p high-sensitivity troponin cystatin c d-dimer and c-reactive protein were associated with hfref.>
  • C-statistic for HFrEF improved with addition of NP (+0.022; P<.001 and high-sensitivity troponin p>
  • For HFpEF, improvement was smaller, with the largest for UACR (+0.010; P=.03).

Limitations

  • Not all biomarkers were available in each cohort.

Coauthored with Antara Ghosh, PhD