A network analysis to compare biomarker profiles in patients with and without diabetes mellitus in acute heart failure.

Published

Journal Article

It is unclear whether distinct pathophysiological processes are present among patients with acute heart failure (AHF), with and without diabetes. Network analysis of biomarkers may identify correlative associations that reflect different pathophysiological pathways.We analysed a panel of 48 circulating biomarkers measured within 24 h of admission for AHF in a subset of patients enrolled in the PROTECT trial. In patients with and without diabetes, we performed a network analysis to identify correlations between measured biomarkers. Compared with patients without diabetes (n = 1111), those with diabetes (n = 922) had a higher prevalence of ischaemic heart disease and traditional coronary risk factors. After multivariable adjustment, patients with and without diabetes had significantly different levels of biomarkers across a spectrum of pathophysiological domains, including inflammation (TNFR-1a, periostin), cardiomyocyte stretch (BNP), angiogenesis (VEGFR, angiogenin), and renal function (NGAL, KIM-1) (adjusted P-value <0.05). Among patients with diabetes, network analysis revealed that periostin strongly clustered with C-reactive protein and interleukin-6. Furthermore, renal markers (creatinine and NGAL) closely associated with potassium and glucose. These findings were not seen among patients without diabetes.Patients with AHF and diabetes, compared with those without diabetes, have distinct biomarker profiles. Network analysis suggests that cardiac remodelling, inflammation, and fibrosis are closely associated with each other in patients with diabetes. Furthermore, potassium levels may be sensitive to changes in renal function as reflected by the strong renal-potassium-glucose correlation. These findings were not seen among patients without diabetes and may suggest distinct pathophysiological processes among AHF patients with diabetes.

Full Text

Duke Authors

Cited Authors

  • Sharma, A; Demissei, BG; Tromp, J; Hillege, HL; Cleland, JG; O'Connor, CM; Metra, M; Ponikowski, P; Teerlink, JR; Davison, BA; Givertz, MM; Bloomfield, DM; Dittrich, H; van Veldhuisen, DJ; Cotter, G; Ezekowitz, JA; Khan, MAF; Voors, AA

Published Date

  • October 2017

Published In

Volume / Issue

  • 19 / 10

Start / End Page

  • 1310 - 1320

PubMed ID

  • 28639369

Pubmed Central ID

  • 28639369

Electronic International Standard Serial Number (EISSN)

  • 1879-0844

International Standard Serial Number (ISSN)

  • 1388-9842

Digital Object Identifier (DOI)

  • 10.1002/ejhf.912

Language

  • eng