The novel urinary proteomic classifier HF1 has similar diagnostic and prognostic utility to B-type natriuretic peptide in heart failure

Campbell, R. T. et al. (2020) The novel urinary proteomic classifier HF1 has similar diagnostic and prognostic utility to B-type natriuretic peptide in heart failure. ESC Heart Failure, (doi: 10.1002/ehf2.12708) (PMID:32383555) (Early Online Publication)

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Abstract

Aims Measurement of B‐type natriuretic peptide (BNP) or N‐terminal pro‐BNP is recommended as part of the diagnostic workup of patients with suspected heart failure (HF). We evaluated the diagnostic and prognostic utility of the novel urinary proteomic classifier HF1, compared with BNP, in HF. HF1 consists of 85 unique urinary peptide fragments thought, mainly, to reflect collagen turnover. Methods and results We performed urinary proteome analysis using capillary electrophoresis coupled with mass spectrometry in 829 participants. Of these, 622 had HF (504 had chronic HF and 118 acute HF) and 207 were controls (62 coronary heart disease patients without HF and 145 healthy controls). The area under the receiver operating characteristic (ROC) curve (AUC) using HF1 for the diagnosis of HF (cases vs. controls) was 0.94 (95% CI, 0.92–0.96). This compared with an AUC for BNP of 0.98 (95% CI, 0.97–0.99). Adding HF1 to BNP increased the AUC to 0.99 (0.98–0.99), P < 0.001, and led to a net reclassification improvement of 0.67 (95% CI, 0.54–0.77), P < 0.001. Among 433 HF patients followed up for a median of 989 days, we observed 186 deaths. HF1 had poorer predictive value to BNP for all‐cause mortality and did not add prognostic information when combined with BNP. Conclusions The urinary proteomic classifier HF1 performed as well, diagnostically, as BNP and provided incremental diagnostic information when added to BNP. HF1 had less prognostic utility than BNP.

Item Type:Articles
Additional Information:JC was supported by a fellowship from the British Society of Heart Failure. Funding to HM and E N-K was provided from the European Commission via the HOMAGE project (HEALTH-FP7-305507).
Status:Early Online Publication
Refereed:Yes
Glasgow Author(s) Enlighten ID:Mischak, Professor Harald and McConnachie, Professor Alex and Delles, Professor Christian and Jackson, Dr Colette and Welsh, Dr Paul and Campbell, Dr Ross and McMurray, Professor John and Cannon, Dr Jane
Authors: Campbell, R. T., Jasilek, A., Mischak, H., Nkuipou-Kenfack, E., Latosinska, A., Welsh, P. I., Jackson, C. E., Cannon, J., McConnachie, A., Delles, C., and McMurray, J. J.V.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
Journal Name:ESC Heart Failure
Publisher:John Wiley & Sons Ltd on behalf of the European Society of Cardiology
ISSN:2055-5822
ISSN (Online):2055-5822
Published Online:08 May 2020
Copyright Holders:Copyright © 2020 The Authors
First Published:First published in ESC Heart Failure, 2020
Publisher Policy:Reproduced under a Creative Commons Licence

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
615391Palliative Care Needs in Patients with Heart FailureJohn McMurrayBritish Heart Foundation (BHF)PG/13/17/30050RI CARDIOVASCULAR & MEDICAL SCIENCES
460362Microvolt T-wave alternans in chronic heart failure: a study of prevalence and incremental prognostic value.Stuart CobbeChief Scientist office (CSO)CZH/4/439SM - MEDICINE, DENTISTRY & NURSING ADMIN
617771BHF centre of excellenceRhian TouyzBritish Heart Foundation (BHF)RE/13/5/30177RI CARDIOVASCULAR & MEDICAL SCIENCES
3039440BHF Centre of ExcellenceRhian TouyzBritish Heart Foundation (BHF)RE/18/6/34217CAMS - Cardiovascular Science