Urinary Proteomics and Outcomes in Heart Failure With Preserved Ejection Fraction.

Autor: Carland C; Hospital of the University of Pennsylvania Philadelphia PA USA.; University of Pennsylvania Perelman School of Medicine Philadelphia PA USA., Zhao L; Bristol-Myers Squibb Company Lawrenceville NJ USA., Salman O; University of Pennsylvania Perelman School of Medicine Philadelphia PA USA., Cohen JB; Hospital of the University of Pennsylvania Philadelphia PA USA.; University of Pennsylvania Perelman School of Medicine Philadelphia PA USA.; Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine University of Pennsylvania Philadelphia PA USA., Zamani P; Hospital of the University of Pennsylvania Philadelphia PA USA.; University of Pennsylvania Perelman School of Medicine Philadelphia PA USA., Xiao Q; Bristol-Myers Squibb Company Lawrenceville NJ USA., Dongre A; Bristol-Myers Squibb Company Lawrenceville NJ USA., Wang Z; Bristol-Myers Squibb Company Lawrenceville NJ USA., Ebert C; Bristol-Myers Squibb Company Lawrenceville NJ USA., Greenawalt D; Bristol-Myers Squibb Company Lawrenceville NJ USA., van Empel V; Department of Cardiology Maastricht University Medical Center Maastricht The Netherlands., Richards AM; Cardiovascular Research Institute, National University of Singapore Singapore.; Christchurch Heart Institute, University of Otago Christchurch New Zealand., Doughty RN; Christchurch Heart Institute, University of Otago Christchurch New Zealand., Rietzschel E; Department of Cardiovascular Diseases Ghent University Hospital and Ghent University Ghent Belgium., Javaheri A; Washington University School of Medicine St. Louis MO USA., Wang Y; Bristol-Myers Squibb Company Lawrenceville NJ USA., Schafer PH; Bristol-Myers Squibb Company Lawrenceville NJ USA., Hersey S; Bristol-Myers Squibb Company Lawrenceville NJ USA., Carayannopoulos LN; Bristol-Myers Squibb Company Lawrenceville NJ USA., Seiffert D; Bristol-Myers Squibb Company Lawrenceville NJ USA., Chang CP; Bristol-Myers Squibb Company Lawrenceville NJ USA., Gordon DA; Bristol-Myers Squibb Company Lawrenceville NJ USA., Ramirez-Valle F; Bristol-Myers Squibb Company Lawrenceville NJ USA., Mann DL; Washington University School of Medicine St. Louis MO USA., Cappola TP; Hospital of the University of Pennsylvania Philadelphia PA USA.; University of Pennsylvania Perelman School of Medicine Philadelphia PA USA., Chirinos JA; Hospital of the University of Pennsylvania Philadelphia PA USA.; University of Pennsylvania Perelman School of Medicine Philadelphia PA USA.
Jazyk: angličtina
Zdroj: Journal of the American Heart Association [J Am Heart Assoc] 2024 May 07; Vol. 13 (9), pp. e033410. Date of Electronic Publication: 2024 Apr 19.
DOI: 10.1161/JAHA.123.033410
Abstrakt: Background: Although several studies have addressed plasma proteomics in heart failure with preserved ejection fraction, limited data are available on the prognostic value of urinary proteomics. The objective of our study was to identify urinary proteins/peptides associated with death and heart failure admission in patients with heart failure with preserved ejection fraction.
Methods and Results: The study population included participants enrolled in TOPCAT (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist Trial). The relationship between urine protein levels and the risk of death or heart failure admission was assessed using Cox regression, in both nonadjusted analyses and adjusting for urine creatinine levels, and the MAGGIC (Meta-Analysis Global Group in Chronic Heart Failure) score. A total of 426 (12.4%) TOPCAT participants had urinary protein data and were included. There were 40 urinary proteins/peptides significantly associated with death or heart failure admission in nonadjusted analyses, 21 of which were also significant adjusted analyses. Top proteins in the adjusted analysis included ANGPTL2 (angiopoietin-like protein 2) (hazard ratio [HR], 0.5731 [95% CI, 0.47-0.7]; P =3.13E-05), AMY2A (α amylase 2A) (HR, 0.5496 [95% CI, 0.44-0.69]; P =0.0001), and DNASE1 (deoxyribonuclease-1) (HR, 0.5704 [95% CI, 0.46-0.71]; P =0.0002). Higher urinary levels of proteins involved in fibrosis (collagen VI α-1, collagen XV α-1), metabolism (pancreatic α-amylase 2A/B, mannosidase α class 1A member 1), and inflammation (heat shock protein family D member 1, inducible T cell costimulatory ligand) were associated with a lower risk of death or heart failure admission.
Conclusions: Our study identifies several novel associations between urinary proteins/peptides and outcomes in heart failure with preserved ejection fraction. Many of these associations are independent of clinical risk scores and may aid in risk stratification in this patient population.
Databáze: MEDLINE
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