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Association of Systemic Thromboxane Generation With Risk of Developing Heart Failure.

Jeffrey J Rade1, Shari S Kronsberg2, Thomas S Kickler3

  • 1Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA.

Journal of the American College of Cardiology
|January 8, 2025
PubMed
Summary
This summary is machine-generated.

Elevated urinary thromboxane B2 metabolites (TXB2-M) signal increased heart failure (HF) risk in individuals without prior HF history. This biomarker may aid in identifying those needing proactive prevention strategies.

Keywords:
aspirinheart failureplateletsthromboxane

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Area of Science:

  • Cardiology
  • Biomarkers
  • Heart Failure Research

Background:

  • Systemic thromboxane A2 generation, assessed via urinary thromboxane B2 metabolites (TXB2-M), is linked to poor cardiac function and mortality in heart failure (HF) patients using aspirin (ASA).
  • The role of TXB2-M in HF development among individuals without a prior HF history and with normal left ventricular function remains unclear.

Purpose of the Study:

  • To investigate the association between urinary TXB2-M levels and the risk of developing HF.
  • To assess this association irrespective of aspirin (ASA) use in individuals with preserved left ventricular ejection fraction (LVEF).

Main Methods:

  • Urinary TXB2-M were measured and adjusted for urine concentration and renal function (TXB2-M_GFR) in 2,611 Framingham Heart Study participants.
  • Participants had no prior HF history and LVEF ≥55%. Cox regression modeled the association of TXB2-M_GFR with HF risk over a median 14.8-year follow-up.

Main Results:

  • Heart failure (HF) developed in 189 participants (7.2%), encompassing both HF with preserved LVEF and HF with reduced LVEF subtypes.
  • Higher TXB2-M_GFR levels were significantly associated with an increased risk of developing HF (HR: 1.81; P < 0.0001), including both HF subtypes.
  • Neither ASA use nor plasma P-selectin levels independently predicted HF risk.

Conclusions:

  • Urinary TXB2-M_GFR is a significant predictor of HF risk, independent of traditional risk factors.
  • Urinary TXB2-M_GFR may serve as a novel biomarker for identifying individuals at high risk for HF.
  • This biomarker could guide aggressive primary prevention strategies for at-risk populations.