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Abnormal circulating steroids refine risk of progression to heart failure in ischemic heart disease

Yangkai Fan1,2, Fengjuan Li1,2, Xin Tan1,2

  • 1Beijing Collaborative Innovation Centre for Cardiovascular Disorders, The Key Laboratory of Remodeling-Related Cardiovascular Disease, Ministry of Education, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

European Journal of Clinical Investigation
|January 12, 2024
PubMed

Insights

Steroid hormone imbalances are linked to heart failure (HF) in ischemic heart disease (IHD) patients. A novel steroid-heart failure score (SHFS) identifies high-risk individuals for targeted interventions.

Area of Science:

  • Cardiology
  • Endocrinology
  • Biomarker Discovery

Background:

  • Ischemic heart disease (IHD) frequently progresses to heart failure (HF) despite existing treatments.
  • Steroid hormone metabolic disorders are increasingly recognized as potential contributors to adverse cardiovascular phenotypes, including HF.

Purpose of the Study:

  • To investigate the association between specific steroid profiles and the risk of developing heart failure in patients with ischemic heart disease.
  • To develop and validate a predictive score based on steroid signatures for incident heart failure.

Main Methods:

  • Quantified 18 steroids using liquid chromatography-tandem mass spectrometry in 2023 patients from the BIOMS-IHD registry.
  • Utilized retrospective discovery and multicenter validation cohorts of IHD patients with a median follow-up of 4 years.
  • Assessed incident heart failure events as the primary outcome.

Main Results:

  • Steroid-based signatures reflecting inflammation, coronary microvascular dysfunction, and left ventricular hypertrophy were associated with subsequent HF events.
  • A high steroid-heart failure score (SHFS > 1) significantly increased the risk of incident HF compared to a low score (SHFS ≤ 1) in both cohorts.
  • The SHFS enhanced prognostic accuracy beyond traditional clinical variables and showed maximal effect in IHD patients with lower B-type natriuretic peptide levels.

Conclusions:

  • A simple, steroid-based strategy effectively identifies IHD patients at higher risk for heart failure.
  • This risk stratification may guide more intensive follow-up and personalized treatment strategies for high-risk individuals.
Abstract

Keywords:
biomarkercoronary microvascular dysfunctionheart failureinflammationischemic heart diseaseleft ventricular hypertrophy

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