The novel urinary proteomic classifier HF1 has similar diagnostic and prognostic utility to BNP in heart failure

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.

Serum and urinary biomarkers of collagen type‐I turnover predict prognosis in patients with heart failure

“…Previous studies indicated an association of biomarkers reflecting collagen turnover with heart failure 1,2 . However, their value in predicting unfavorable outcomes is unknown.…”

“…The Ethics Committee of the University of Aachen approved the secondary use of anonymized data and the biomarker measurements (number EK163/19). Tianlin He 1,2 Jesus D. Melgarejo 3 Andrew L. Clark 4 Yu-Ling Yu 3 Lutgarde Thijs 3 Javier Díez 5,6,7 Begoña López 5,6,7 Arantxa González 5,6,7 John G. Cleland 8 Joost P. Schanstra 9,10 Antonia Vlahou 11 Agnieszka Latosinska 1 Harald Mischak 1,12 Jan A. Staessen 3,13 Zhen-Yu Zhang 3…”

Critical COVID-19 represents an endothelial disease with high similarity to kidney disease on the molecular level

“…For each peptide, fold change in disease vs. controls was calculated. Similarly, the fold change was also assessed for HF, investigating 773 datasets from HF patients compared to 773 controls [15]. To define the changes observed in AKI, data from 94 patients with AKI (KDIGO grade 2 and 3) were compared to controls (KDIGO grade 0, n=348) [16].…”

Current applications of capillary electrophoresis‐mass spectrometry for the analysis of biologically important analytes in urine (2017 to mid‐2021): A review

“…The following three articles study the potential of a novel classifier HF1 based on 85 urine peptide fragments. Campbell et al [116] studied the urinary proteome of 829 individuals (622 with chronic or acute heart failure and 207 healthy controls). The study founds that the HF1 classifier allows discrimination between patients with heart fail-ure, healthy controls, and coronary heart disease (but without heart failure).…”