Abstract 10494: Proteomic Assessment of Novel Kidney Function Biomarkers in Heart Failure: A Community Study

Abstract

Introduction: Heart failure (HF) is a complex syndrome with high mortality often associated with impaired kidney function. Estimated glomerular filtration rate (eGFR) is central to kidney function assessment in HF. However, novel proteins related to kidney function (lipocalin 2 [LCN2], macrophage inhibitory cytokine 1 [MIC1], T cell immunoglobulin and mucin domain 1 [TIM1]) may improve risk stratification of HF patients, beyond eGFR. Their prognostic contribution remain to be fully explored. Hypothesis: Proteomic assessment of kidney function biomarkers improves risk stratification in HF. Methods: Clinical data and biospecimens were collected from a HF community cohort in Southeastern Minnesota from 2003-2012. Serum creatinine was measured in 1,388 patients and eGFR was calculated with the 2021 Chronic Kidney Disease (CKD) Epidemiology Collaboration equation. CKD was defined as an eGFR <60 mL/min/1.73m 2 . Plasma proteins were measured using the SomaLogic aptamer-based technology SomaScan®. In HF patients with and without CKD, Cox proportional hazard models were used to estimate the association between kidney function biomarkers and mortality, after adjustment for Meta-Analysis Global Group in Chronic HF (MAGGIC) risk score. Results: At HF index, patients were on average 75±13 years of age and 48% female. Patients had a median eGFR of 57 mL/min/1.73m 2 and 64% had CKD. Adjusted geometric mean levels of LCN2, MIC1, and TIM1 levels were 20-30% higher in patients with CKD. Patients with CKD were at higher risk of dying (HR 1.6, 95% CI 1.4-1.8). Patients with above median levels of LCN2, TIM1, MIC1 were at higher risk of dying, irrespective of CKD (See Figure). Conclusions: In a HF community cohort, several novel kidney function biomarkers provided further risk stratification in patients with and without CKD.