Elevated levels of circulating biomarkers, such as NT-proBNP (HR 2.03; 95% CI 1.82-2.25; P<0.01), were significantly associated with an increased risk of incident heart failure.
Meta-Analysis
Are elevated levels of cardiac, oxidative stress, and fibrosis-related biomarkers associated with an increased risk of incident heart failure in individuals without prior HF?
Multiple circulating biomarkers, notably NT-proBNP, hs-cTnI, and hs-cTnT, are significantly associated with the development of incident heart failure in the general population, supporting their utility for early risk stratification.
Hazard Ratio: 2.03 (95% CI 1.82–2.25)
p-value: p=< 0.01
Background Circulating biomarkers reflecting pathophysiological pathways, including myocardial stress, injury, oxidative stress, and fibrosis, may facilitate early identification of individuals at increased risk of heart failure (HF) in the general population. However, the strength and consistency of associations between these biomarkers and incident HF have not been comprehensively evaluated. Methods A comprehensive search of relevant databases (inception-September 2024) identified population-based studies reporting biomarkers associated with incident HF in individuals without a prior HF history. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using a random effects meta-analysis. Results Across 47 included studies, nine biomarkers were significantly associated with new-onset HF in multivariate-adjusted analyses: N-terminal pro b-type natriuretic peptide (NT-proBNP) (HR 2.03, 95% CI: 1.82-2.25, P < 0.01), high-sensitivity cardiac troponin I (hs-cTnI) (HR 1.58, 95% CI: 1.42-1.76, P < 0.01), high-sensitivity cardiac troponin T (hs-cTnT) (HR 1.74, 95% CI: 1.36-2.22, P < 0.01), midregional pro-atrial natriuretic peptide (MR-proANP) (HR 1.54, 95% CI: 1.39-1.71, P < 0.01), b-type natriuretic peptide (BNP) (HR 1.57, 95% CI: 1.44-1.71, P < 0.01), growth differentiation factor 15 (GDF-15) (HR 1.51, 95% CI: 1.36-1.68, P < 0.01), midregional proadrenomedullin (MR-proADM) (HR 1.38, 95% CI: 1.10-1.74, P < 0.01), fibroblast growth factor 23 (FGF-23) (HR 1.17, 95% CI: 1.10-1.25, P < 0.01), and galectin-3 (Gal-3) (HR 1.23, 95% CI: 1.12-1.35, P < 0.01). HF phenotypes and sex differences were also evaluated. Conclusions Higher levels of NT-proBNP, hs-cTnI, hs-cTnT, MR-proANP, BNP, GDF-15, MR-proADM, FGF-23, and Gal-3 were associated with a larger risk of incident HF, supporting their utility as biomarkers for predicting HF development.
Noordermeer et al. (Fri,) conducted a meta-analysis in New-onset heart failure. Elevated circulating biomarkers (e.g., NT-proBNP) vs. Lower biomarker levels was evaluated on New-onset heart failure (HR 2.03, 95% CI 1.82-2.25, p=< 0.01). Elevated levels of circulating biomarkers, such as NT-proBNP (HR 2.03; 95% CI 1.82-2.25; P<0.01), were significantly associated with an increased risk of incident heart failure.