Open AccessThe novel urinary proteomic classifier HF1 has similar diagnostic and prognostic utility to BNP in heart failure
Author(s) -
Campbell Ross T.,
Jasilek Adam,
Mischak Harald,
NkuipouKenfack Esther,
Latosinska Agnieszka,
Welsh Paul I.,
Jackson Colette E.,
Can Jane,
McConnachie Alex,
Delles Christian,
McMurray John J.V.
Publication year - 2020
Publication title -
esc heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.787
H-Index - 25
ISSN - 2055-5822
DOI - 10.1002/ehf2.12708
Subject(s) - medicine , natriuretic peptide , heart failure , receiver operating characteristic , urinary system , area under the curve , cardiology , gastroenterology , brain natriuretic peptide
Aims Measurement of B‐type natriuretic peptide (BNP) or N‐terminal pro‐BNP is recommended as part of the diagnostic workup of patients with suspected heart failure (HF). We evaluated the diagnostic and prognostic utility of the novel urinary proteomic classifier HF1, compared with BNP, in HF. HF1 consists of 85 unique urinary peptide fragments thought, mainly, to reflect collagen turnover. Methods and results We performed urinary proteome analysis using capillary electrophoresis coupled with mass spectrometry in 829 participants. Of these, 622 had HF (504 had chronic HF and 118 acute HF) and 207 were controls (62 coronary heart disease patients without HF and 145 healthy controls). The area under the receiver operating characteristic (ROC) curve (AUC) using HF1 for the diagnosis of HF (cases vs. controls) was 0.94 (95% CI, 0.92–0.96). This compared with an AUC for BNP of 0.98 (95% CI, 0.97–0.99). Adding HF1 to BNP increased the AUC to 0.99 (0.98–0.99), P < 0.001, and led to a net reclassification improvement of 0.67 (95% CI, 0.54–0.77), P < 0.001. Among 433 HF patients followed up for a median of 989 days, we observed 186 deaths. HF1 had poorer predictive value to BNP for all‐cause mortality and did not add prognostic information when combined with BNP. Conclusions The urinary proteomic classifier HF1 performed as well, diagnostically, as BNP and provided incremental diagnostic information when added to BNP. HF1 had less prognostic utility than BNP.