Association of Cardiovascular Biomarkers With Incident Heart Failure With Preserved and Reduced Ejection Fraction

• DOI: 10.1001/jamacardio.2017.4987
• Publication Date: 2018-01-11T01:31:20Z
• Authors: Rudolf A. de Boer; Matthew Nayor; Christopher R. de...; Danielle Enserro; Vijeta Bhambhani; Jorge R. Kizer; Michael J. Blaha; Frank P. Brouwers; Mary Cushman; Joao A. C. Lima; Hossein Bahrami; Pim van der Harst; Thomas J. Wang; Ron T. Gansevoort; Caroline S. Fox; Hanna K Gaggin; Willem J. Kop; Kiang Liu; Ramachandran S. V...; Bruce M. Psaty; Douglas S. Lee; Hans L. Hillege; Traci M. Bartz; Emelia J. Benjamin; Cheeling Chan; Matthew Allison; Julius M. Gardin; James L. Januzzi; Sanjiv J. Shah; Daniel Levy; David M. Herrington; Martin G. Larson; Wiek H. van Gilst; John S. Gottdiener; Alain G. Bertoni; Jennifer E. Ho
• Keywords: Framingham Heart Study; Brain natriuretic peptide

<h3>Importance</h3> Nearly half of all patients with heart failure have preserved ejection fraction (HFpEF) as opposed to reduced (HFrEF), yet associations biomarkers future subtype are incompletely understood. <h3>Objective</h3> To evaluate the 12 cardiovascular incident HFpEF vs HFrEF among adults from general population. <h3>Design, Setting, and Participants</h3> This study included 4 longitudinal community-based cohorts: Cardiovascular Health Study (1989-1990; 1992-1993 for supplemental African-American cohort), Framingham Heart (1995-1998), Multi-Ethnic Atherosclerosis (2000-2002), Prevention Renal Vascular End-stage Disease (1997-1998). Each cohort had prospective ascertainment HFrEF. Data analysis was performed June 25, 2015, November 9, 2017. <h3>Exposures</h3> The following were examined: N-terminal pro B-type natriuretic peptide or brain peptide, high-sensitivity troponin T I, C-reactive protein (CRP), urinary albumin creatinine ratio (UACR), renin aldosterone ratio, D-dimer, fibrinogen, soluble suppressor tumorigenicity, galectin-3, cystatin C, plasminogen activator inhibitor 1, interleukin 6. <h3>Main Outcomes Measures</h3> Development <h3>Results</h3> Among 22 756 participants in these cohorts (12 087 women 10 669 men; mean [SD] age, 60 [13] years) study, during a median follow-up years, 633 developed HFpEF, 841 In models adjusted clinical risk factors failure, 2 significantly associated HFpEF: UACR (hazard [HR], 1.33; 95% CI, 1.20-1.48;<i>P</i> &lt; .001) peptides (HR, 1.27; 1.16-1.40;<i>P</i> .001), suggestive 1.11; 1.03-1.19;<i>P</i> = .008), 1 1.22; 1.03-1.45;<i>P</i> .02), fibrinogen 1.12; 1.03-1.22;<i>P</i> .01). By contrast, 6 HFrEF: 1.54; 1.41-1.68;<i>P</i> 1.21; 1.11-1.32;<i>P</i> 1.37; 1.29-1.46;<i>P</i> C 1.19; 1.11-1.27;<i>P</i> D-dimer 1.11-1.35;<i>P</i> CRP 1.11-1.28;<i>P</i> .001). When directly compared, peptides, troponin, more strongly compared HFpEF. <h3>Conclusions Relevance</h3> Biomarkers renal dysfunction, endothelial inflammation only These findings highlight need studies focused on identifying novel