Bloodstream levels of a protein fragment called endotrophin can be used to predict outcomes in patients with a common form of heart failure, according to a study co-led by researchers at the Perelman School of Medicine at the University of Pennsylvania.
The findings, published in New England Journal of Medicine Evidence, suggest that blood testing for endotrophin may eventually become a standard part of cardiologists’ toolkits for assessing heart failure patients. The findings apply particularly to the common form of heart failure called heart failure with preserved ejection fraction (HFpEF).
In the study, the researchers investigated endotrophin blood levels as a potential prognostic biomarker for HFpEF. Researchers first analyzed endotrophin levels in blood samples taken from 205 HFpEF patients at the outset of a previous clinical trial. They split the patients into three tiers, or “tertiles,” according to their endotrophin blood levels, and compared how they fared in the trial.
The results were striking. Over a four-year follow-up period, patients in the highest tertile, compared to those in the lowest, had several fold increased risk of having a heart attack, being hospitalized for the management of heart failure, or dying from any cardiovascular cause. Patients in the highest tertile also had several fold increased rate of death from any cause during those four years, compared to patients in the lowest tertile.
The researchers then measured endotrophin in samples from additional studies and found similar results in analyses of five other HFpEF cohorts. Perhaps most importantly, they determined that endotrophin levels were a better predictor of most severe HFpEF outcomes when compared to two other prognostic indicators already in use: a risk-scoring system called MAGGIC that is based on the patient’s age, weight, smoking status, and other factors; and a blood-based biomarker called NT-proBNP.