Key result
Non-obese HF linked to ~26-fold higher 2-year mortality compared to obese patients.
Why the study?
Identification of novel circulating biomarkers predicting death and major cardio-metabolic events in obese patients with heart failure remains a research priority due to lack of specific guidelines and understanding of the obesity paradox phenotype.
Observational (n=16)
No
Odds Ratio: 26 (95% CI 1.14–624)
Absolute Event Rate: 63% vs 0%
p-value: p=<0.04
Non-obese HF patients showed higher mortality; leaves open whether protein signatures mediate protection or reflect confounding, precluding practice change.
Identification of novel circulating biomarkers predicting death and major cardio-metabolic events in obese patients with heart failure (HF) remains a research priority. In this study, we compared multi-marker profile of non-obese (NOB) and obese (OB) HF patients in relation to mortality outcome. The new multiplex proximity extension assay technology was used to analyze the levels of 92 proteins in plasma samples from HF patients according to body mass index (BMI) categories. At 2-year follow-up, all-cause mortality rates were significantly greater in NOB patients (BMI < 30 kg/m2) compared to the OB patients (BMI > 30 kg/m2) with HF (odds ratio 26; 95% CI: 1.14–624, p < 0,04). Quantitative proteomic analysis revealed thirteen distinct proteins expression profiles of OB and NOB HF patients. Among these proteins, RAGE, CXCL6, CXCL1, CD40, NEMO, VEGF-A, KLK6, PECAM1, PAR1, MMP1, BNP and NTproBNP were down-regulated, whereas leptin was up-regulated in OB HF patients. In addition, an inverse correlation between plasma BNP levels and leptin in OB HF patients was observed (r = −0.58 p = 0.02). This study identifies specific plasma protein signature in OB and NOB patients with HF in relation to mortality outcome.
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Cinato et al. (2018) conducted an observational in Heart failure (n=16). Non-obese (BMI < 30 kg/m2) vs. Obesity (BMI ≥ 30 kg/m2) was evaluated on All-cause mortality at 2-year follow-up (odds ratio 26, 95% CI 1.14-624, p=<0.04). Non-obese heart failure patients exhibited a significantly higher 2-year all-cause mortality rate compared to obese patients (OR 26), alongside distinct pro-inflammatory and pro-angiogenic plasma protein signatures.
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