An 11-protein plasma proteomics-based model accurately predicted worsening heart failure in patients with hypertrophic cardiomyopathy (AUC 0.87; 95% CI 0.76 to 0.98).
Cohort (n=389)
Yes
Can a plasma proteomics-based model predict worsening heart failure in patients with hypertrophic cardiomyopathy?
A novel 11-protein plasma proteomics model demonstrated high accuracy in predicting worsening heart failure in patients with hypertrophic cardiomyopathy, implicating the Ras-MAPK pathway.
Effect estimate: AUC 0.87 (95% CI 0.76 to 0.98)
OBJECTIVE: Heart failure (HF) is one of the most common and lifestyle-limiting complications of hypertrophic cardiomyopathy (HCM). Prediction of worsening HF using clinical measures alone remains limited. Moreover, the mechanisms by which patients with HCM develop worsening HF have not been elucidated. Therefore, the aim of this study was to develop a plasma proteomics-based model to predict worsening HF among patients with HCM and to identify signalling pathways that are differentially regulated in those who subsequently develop worsening HF. METHODS: In this multi-centre, prospective cohort study of 389 patients with HCM, plasma proteomics profiling of 4986 proteins was performed at enrolment. A proteomics-based random forest model was developed to predict worsening HF using data from one institution (training set, n=268). This model was externally validated in patients from a different institution (test set, n=121). Pathway analysis of proteins significantly dysregulated in patients who subsequently developed worsening HF compared with those who did not was executed, using a false discovery rate (FDR) threshold of <0.001. RESULTS: Using the 11-protein proteomics-based model derived from the training set, the area under the receiver-operating characteristic curve to predict worsening HF was 0.87 (95% CI: 0.76 to 0.98) in the test set. Pathway analysis revealed that the Ras-MAPK pathway (FDR<0.00001) and related pathways were dysregulated in patients who subsequently developed worsening HF. CONCLUSIONS: The present study with comprehensive plasma proteomics profiling demonstrated a high accuracy to predict worsening HF in patients with HCM and identified the Ras-MAPK and related signalling pathways as potential underlying mechanisms.
Lumish et al. (Fri,) conducted a cohort in Hypertrophic cardiomyopathy (n=389). Plasma proteomics profiling was evaluated on Prediction of worsening heart failure (AUC 0.87, 95% CI 0.76 to 0.98). An 11-protein plasma proteomics-based model accurately predicted worsening heart failure in patients with hypertrophic cardiomyopathy (AUC 0.87; 95% CI 0.76 to 0.98).