The multi-biomarker approach for heart failure in patients with hypertension

Area of Science:

• Cardiology
• Biomarker Discovery
• Hypertension Research

Background:

• Hypertension is a major risk factor for heart failure (HF).
• Early and accurate prediction of HF in hypertensive patients is crucial for timely intervention.
• N-terminal pro-brain natriuretic peptide (NT-proBNP) is a recognized biomarker for HF, but its predictive ability may be enhanced by other markers.

Purpose of the Study:

• To evaluate the predictive capabilities of various biomarkers for HF in hypertensive individuals.
• To establish a multi-biomarker approach for improved HF detection and prognosis in this population.
• To compare the performance of individual biomarkers and multi-biomarker panels against NT-proBNP.

Main Methods:

• A cohort of 120 hypertensive patients, with or without overt HF, was studied.
• The predictive value of NT-proBNP, transforming growth factor-beta (TGF-β), cardiotrophin-1 (CT-1), cystatin C (CysC), and others were assessed using receiver operating characteristic (ROC) curve analysis.
• Multi-biomarker panels were constructed and their predictive ability for HF was evaluated.

Main Results:

• NT-proBNP (AUC=0.873) and TGF-β (AUC=0.878) demonstrated the highest discriminative value for HF.
• Specific thresholds for CT-1, TGF-β, syndecan-4, NT-proBNP, CysC, and NGAL were identified as significant predictors of overt HF.
• A multi-biomarker panel combining NT-proBNP, TGF-β, CT-1, and CysC showed only a marginal improvement over a panel with NT-proBNP, TGF-β, and CT-1.

Conclusions:

• Biomarkers including NT-proBNP, TGF-β, CT-1, and CysC offer additive prognostic value for incident HF in hypertensive patients.
• A multi-biomarker strategy incorporating markers with distinct pathophysiological roles may enhance HF prediction beyond NT-proBNP alone.
• Further validation of these multi-biomarker panels is warranted for clinical application in hypertensive HF management.