Clinical and proteomic profiles of chronic kidney disease in heart failure with reduced and preserved ejection fraction

TY - JOUR

T1 - Clinical and proteomic profiles of chronic kidney disease in heart failure with reduced and preserved ejection fraction

AU - Voordes, Geert H.D.

AU - Voors, Adriaan A.

AU - Hoegl, Annabelle

AU - Madsen, Christian T.

AU - van Essen, Bart J.

AU - Ouwerkerk, Wouter

AU - Tromp, Jasper

AU - de la Rambelje, Mark A.

AU - Grønborg, Mads

AU - Refsgaard, Jan C.

AU - Lang, Chim C.

AU - Barascuk-Michaelsen, Natasha

AU - Damman, Kevin

N1 - Publisher Copyright: © 2024 The Authors

PY - 2024/12/15

Y1 - 2024/12/15

N2 - Background Chronic kidney disease (CKD) is prevalent and related to poor clinical outcomes in patients with heart failure (HF). The pathophysiology of CKD in HF with a reduced ejection fraction (HFrEF) and HF with a preserved ejection fraction (HFpEF) is not well defined. In this study we compared clinical and proteomic profiles of CKD between patients with HFrEF and HFpEF. Methods We included 478 patients of the Scottish BIOSTAT-CHF cohort, of which 246 had HFrEF and 232 had HFpEF. CKD was defined as an eGFR <60 mL/min/1.73m2. We compared HFrEF-patients with CKD to HFpEF-patients with CKD using logistic- and Cox-regression. We performed a differential expression analysis using 6376 proteins.Results The prevalence of CKD was 36 % and 32 % in patients with HFpEF and HFrEF, respectively. CKD patients were on average 7 years older. BMI, higher NT-proBNP, ACE-inhibitors, HDL-cholesterol and Stroke were associated with CKD- patients with HFrEF. In HFpEF, CKD was associated with MRA-use and higher platelet count. CKD was associated with increased risk of death or heart failure hospitalization (HR 1.82, p < 0.001), with similar effect in HFrEF and HFpEF. The pattern of differentially expressed proteins between patients with and without CKD was similar in both HF-groups. ConclusionClinical profiles related to CKD- patients with HFrEF were different from CKD-patients with HFrEF. CKD was associated with an increased risk of death or heart failure hospitalization, which was not different between HFpEF and HFrEF. Patterns of circulating proteins were similar between CKD-patients with HFpEF and HFrEF, suggesting no major differences in CKD-pathophysiology.

AB - Background Chronic kidney disease (CKD) is prevalent and related to poor clinical outcomes in patients with heart failure (HF). The pathophysiology of CKD in HF with a reduced ejection fraction (HFrEF) and HF with a preserved ejection fraction (HFpEF) is not well defined. In this study we compared clinical and proteomic profiles of CKD between patients with HFrEF and HFpEF. Methods We included 478 patients of the Scottish BIOSTAT-CHF cohort, of which 246 had HFrEF and 232 had HFpEF. CKD was defined as an eGFR <60 mL/min/1.73m2. We compared HFrEF-patients with CKD to HFpEF-patients with CKD using logistic- and Cox-regression. We performed a differential expression analysis using 6376 proteins.Results The prevalence of CKD was 36 % and 32 % in patients with HFpEF and HFrEF, respectively. CKD patients were on average 7 years older. BMI, higher NT-proBNP, ACE-inhibitors, HDL-cholesterol and Stroke were associated with CKD- patients with HFrEF. In HFpEF, CKD was associated with MRA-use and higher platelet count. CKD was associated with increased risk of death or heart failure hospitalization (HR 1.82, p < 0.001), with similar effect in HFrEF and HFpEF. The pattern of differentially expressed proteins between patients with and without CKD was similar in both HF-groups. ConclusionClinical profiles related to CKD- patients with HFrEF were different from CKD-patients with HFrEF. CKD was associated with an increased risk of death or heart failure hospitalization, which was not different between HFpEF and HFrEF. Patterns of circulating proteins were similar between CKD-patients with HFpEF and HFrEF, suggesting no major differences in CKD-pathophysiology.

KW - CKD

KW - Heart Failure

KW - HFpEF

KW - HFrEF

KW - Proteomics

UR - https://www.scopus.com/pages/publications/85204443560

U2 - 10.1016/j.ijcard.2024.132580

DO - 10.1016/j.ijcard.2024.132580

M3 - Article

C2 - 39306286

AN - SCOPUS:85204443560

SN - 0167-5273

VL - 417

JO - International Journal of Cardiology

JF - International Journal of Cardiology

M1 - 132580

ER -