Abstract 18479: New Heart Failure Diagnostic and Prognostic Biomarkers Discovered Using Capillary Electrophoresis Coupled to Mass Spectroscopy
Blood heart failure (HF) biomarkers such as the natriuretic peptides (NP) are widely used but the NP biomarker family has limitations and HF diagnosis remains too often complicated because of atypical presentations and the need of specialized care access. More specific and accurate biomarkers with detection method allowing for facilitated large scale HF screenings are required. Indeed, 30 % of the patients admitted to emergency care for acute dyspnea have a BNP concentration in a « grey zone » that do not allow for diagnosis. Thus, diagnosis of these patients is costly and time-consuming while a rapid medical care of the patient has a positive impact on his health and reduces the treatment cost. Therefore, we have launched a prospective multicentric case-control study and investigated for urinary polypetides specific to acute (AHF) or chronic heart failure (CHF), using a capillary electrophoresis-mass spectroscopy strategy (CE-MS). Based on a screen of the urinary proteome of patients (CHF, AHF, and healthy controls matched for cardiovascular risk factors), we revealed a panel of polypeptides specific to HF. One polypeptide (X64, patent pending) seemed very relevant because it could discriminate AHF and CHF with a high specificity and specificity (AUC = 0,99; p<0,0001). X64 plasma levels were assessed within Atlanta (n=340, follow-up 3 years) and Toulouse (n=187, follow-up 6 years) cohorts. The Atlanta cohort revealed that X64 level is associated with major clinical events: HR: 1.23 per 100 ng/mL (95% CI: 1.06 to 1.43); P=0.005 and with HF admissions: IRR: 1.20 per 100 ng/mL (95% CI: 1.00 to 1.44); P=0.05. Moreover, the Toulouse cohort revealed that high X64 levels were strong predictors of cardiac death (p<0.0001). Our work provides with new biomarkers allowing for HF diagnosis in the BNP « grey zone » or prognosis and therefore allow for a better care of the HF patients at the hospital but also in general care.
- © 2013 by American Heart Association, Inc.