A network analysis to compare biomarker profiles in patients with and without diabetes mellitus in acute heart failure

Sharma, A. et al. (2017) A network analysis to compare biomarker profiles in patients with and without diabetes mellitus in acute heart failure. European Journal of Heart Failure, 19(10), pp. 1310-1320. (doi: 10.1002/ejhf.912) (PMID:28639369)

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Aims: It is unclear whether distinct pathophysiological processes are present among patients with acute heart failure (AHF), with and without diabetes. Network analysis of biomarkers may identify correlative associations that reflect different pathophysiological pathways. Methods and results: We analysed a panel of 48 circulating biomarkers measured within 24 h of admission for AHF in a subset of patients enrolled in the PROTECT trial. In patients with and without diabetes, we performed a network analysis to identify correlations between measured biomarkers. Compared with patients without diabetes (n = 1111), those with diabetes (n = 922) had a higher prevalence of ischaemic heart disease and traditional coronary risk factors. After multivariable adjustment, patients with and without diabetes had significantly different levels of biomarkers across a spectrum of pathophysiological domains, including inflammation (TNFR-1a, periostin), cardiomyocyte stretch (BNP), angiogenesis (VEGFR, angiogenin), and renal function (NGAL, KIM-1) (adjusted P-value <0.05). Among patients with diabetes, network analysis revealed that periostin strongly clustered with C-reactive protein and interleukin-6. Furthermore, renal markers (creatinine and NGAL) closely associated with potassium and glucose. These findings were not seen among patients without diabetes. Conclusion: Patients with AHF and diabetes, compared with those without diabetes, have distinct biomarker profiles. Network analysis suggests that cardiac remodelling, inflammation, and fibrosis are closely associated with each other in patients with diabetes. Furthermore, potassium levels may be sensitive to changes in renal function as reflected by the strong renal–potassium–glucose correlation. These findings were not seen among patients without diabetes and may suggest distinct pathophysiological processes among AHF patients with diabetes.

Item Type:Articles
Additional Information:The PROTECT trial was supported by NovaCardia, a subsidiary of Merck.
Glasgow Author(s) Enlighten ID:Cleland, Professor John
Authors: Sharma, A., Demissei, B. G., Tromp, J., Hillege, H. L., Cleland, J. G.F., O'Connor, C. M., Metra, M., Ponikowski, P., Teerlink, J. R., Davison, B. A., Givertz, M. M., Bloomfield, D. M., Dittrich, H., van Veldhuisen, D. J., Cotter, G., Ezekowitz, J. A., Khan, M. A.F., and Voors, A. A.
Subjects:R Medicine > R Medicine (General)
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
Journal Name:European Journal of Heart Failure
ISSN (Online):1879-0844
Published Online:21 June 2017
Copyright Holders:Copyright © 2017 European Society of Cardiology
First Published:First published in European Journal of Heart Failure 19(10):1310+1320
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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