Key result
Higher plasma HK is linked to ~31% increased incident heart failure risk in stable CAD.
Why the study?
The kynurenine pathway, linking tryptophan metabolism to inflammation, oxidative stress, and cell death, had not been studied as a pathway associated with risk for incident HF.
Does higher serum 3-hydroxykynurenine (HK) predict incident heart failure in patients with predominantly stable coronary artery disease?
Cohort (n=3,841)
Yes
Does higher serum 3-hydroxykynurenine (HK) predict incident heart failure in patients with predominantly stable coronary artery disease?
Hazard Ratio: 1.31 (95% CI 1.07–1.46)
p-value: p=<0.001
Elevated plasma levels of the kynurenine metabolite 3-hydroxykynurenine (HK) are independently associated with an increased risk of incident heart failure in patients with stable coronary artery disease.
May stratify HF risk in stable CAD; leaves open whether kynurenine pathway targeting alters outcomes.
Background: Inflammation and immune activation contribute to the development and progression of heart failure (HF). The kynurenine pathway, linking tryptophan metabolism to inflammation, oxidative stress, and cell death by way of its metabolites (kynurenines), has not been studied as a pathway associated with risk for incident HF. Aims: To investigate whether kynurenine metabolites are associated with incident HF in patients with predominantly stable coronary artery disease. Methods: Serum kynurenine metabolites were quantified in 3841 patients who underwent elective coronary angiography for evaluation of chest pain. Fasting was not routine. Patients with established HF at baseline were excluded. The hazard for incident HF was estimated using Cox regression, adjusted for age, gender, current smoking, diabetes, hypertension, previous myocardial infarction, body mass index, glomerular filtration rate, troponin T, left ventricular ejection fraction, and resting heart rate. Results: < .001). Conclusion: Higher plasma HK was independently associated with incident HF in patients with predominantly stable coronary artery disease. These findings support a possible link between kynurenine pathway activity and future HF risk, but the underlying mechanisms and clinical implications remain to be established.
No takes yet. Share an insight, caveat, or question.
Lund et al. (2026) conducted a cohort in Predominantly stable coronary artery disease without baseline heart failure (n=3,841). 3-hydroxykynurenine (HK) levels vs. Lower 3-hydroxykynurenine (HK) levels was evaluated on Incident heart failure (HR 1.31, 95% CI 1.07-1.46, p=<0.001). Higher plasma 3-hydroxykynurenine (HK) was independently associated with an increased risk of incident heart failure (HR 1.31) in patients with predominantly stable coronary artery disease.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: