Evidence map›Paper›PMID 38516784›Full record

SynthesisCirculation. Genomic and precision medicine2024

Incremental Value of a Metabolic Risk Score for Heart Failure Mortality: A Population-Based Study.

Jungnam Joo, Joseph J Shearer, Anna Wolska, Alan T Remaley, James D Otvos, Margery A Connelly, Maureen Sampson, Suzette J Bielinski, Nicholas B Larson, Hoyoung Park and 3 more

Open access · greenAbstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Circulation. Genomic and precision medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
2.4field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Prognostic value of 9 immune-inflammatory markers for patients with dilated cardiomyopathy: A retrospective study.International journal of cardiology. Cardiovascular risk and prevention · 2026
    Article
  3. Article
  4. Review
  5. Article
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 5 institutions in 2 countries.

Jungnam Joo *Office of Biostatistics Research (J.J.), National Heart, Lung, and Blood Institute, Bethesda, MD.ORCID 0000-0001-6961-8122
Joseph J Shearer *Heart Disease Phenomics Laboratory, Epidemiology and Community Health Branch (J.J.S., K.M.C., S.T., V.L.R.), National Heart, Lung, and Blood Institute, Bethesda, MD.ORCID 0000-0002-1443-7428
Anna WolskaLipoprotein Metabolism Laboratory, Translational Vascular Medicine Branch (A.W., A.T.R., J.D.O.), National Heart, Lung, and Blood Institute, Bethesda, MD.ORCID 0000-0001-9479-0741
Alan T RemaleyLipoprotein Metabolism Laboratory, Translational Vascular Medicine Branch (A.W., A.T.R., J.D.O.), National Heart, Lung, and Blood Institute, Bethesda, MD.ORCID 0000-0003-2473-5549
James D OtvosLipoprotein Metabolism Laboratory, Translational Vascular Medicine Branch (A.W., A.T.R., J.D.O.), National Heart, Lung, and Blood Institute, Bethesda, MD.ORCID 0000-0001-5686-7103
Margery A ConnellyLabcorp, Morrisville, NC (M.A.C.).ORCID 0000-0002-3917-592X
Maureen SampsonDepartment of Laboratory Medicine, Clinical Center, National Institutes of Health, Bethesda, MD (M.S.).ORCID 0000-0003-0885-250X
Suzette J BielinskiDivision of Epidemiology, Department of Quantitative Health Sciences (S.J.B.).ORCID 0000-0002-2905-5430
Nicholas B LarsonDivision of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic College of Medicine and Science, Rochester, MN (N.B.L.).ORCID 0000-0002-3468-4215
Hoyoung ParkDepartment of Statistics, Sookmyung Women's University, Seoul, Korea (H.P.).ORCID 0000-0002-0184-1309
Katherine M ConnersHeart Disease Phenomics Laboratory, Epidemiology and Community Health Branch (J.J.S., K.M.C., S.T., V.L.R.), National Heart, Lung, and Blood Institute, Bethesda, MD.
Sarah TurecamoHeart Disease Phenomics Laboratory, Epidemiology and Community Health Branch (J.J.S., K.M.C., S.T., V.L.R.), National Heart, Lung, and Blood Institute, Bethesda, MD.
Véronique L RogerHeart Disease Phenomics Laboratory, Epidemiology and Community Health Branch (J.J.S., K.M.C., S.T., V.L.R.), National Heart, Lung, and Blood Institute, Bethesda, MD.ORCID 0000-0002-9347-7865
National Heart Lung and Blood Institute · USLabCorp (United States) · USMayo Clinic in Florida · USNational Institutes of Health Clinical Center · USSookmyung Women's University · KR

Funding

Interdisciplinary Infrastructure for Aging Research: Rochester Epidemiology ProjectR33AG058738 · NIA · MAYO CLINIC ROCHESTER · PI LEBRASSEUR, NATHAN K, OLSON, JANET E · 2020 to 2022
$2.4M
Heart failure Metabolomics: NMR studiesZIAHL006278 · NHLBI · NATIONAL HEART, LUNG, AND BLOOD INSTITUTE · PI ROGER, VERONIQUE · 2022 to 2025
$2.0M
Interdisciplinary Infrastructure for Aging Research: Rochester Epidemiology ProjectR21AG058738 · NIA · MAYO CLINIC ROCHESTER · PI LEBRASSEUR, NATHAN K, OLSON, JANET E · 2018 to 2019
$437k
Intramural NIH HHS ZIA HL006278NIA NIH HHS R21 AG058738NIA NIH HHS R33 AG058738
6 · The paper itself

Abstract

backgroundHeart failure is heterogeneous syndrome with persistently high mortality. Nuclear magnetic resonance spectroscopy enables high-throughput metabolomics, suitable for precision phenotyping. We aimed to use targeted metabolomics to derive a metabolic risk score (MRS) that improved mortality risk stratification in heart failure.

methodsNuclear magnetic resonance was used to measure 21 metabolites (lipoprotein subspecies, branched-chain amino acids, alanine, GlycA (glycoprotein acetylation), ketone bodies, glucose, and citrate) in plasma collected from a heart failure community cohort. The MRS was derived using least absolute shrinkage and selection operator penalized Cox regression and temporal validation. The association between the MRS and mortality and whether risk stratification was improved over the Meta-Analysis Global Group in Chronic Heart Failure clinical risk score and NT-proBNP (N-terminal pro-B-type natriuretic peptide) levels were assessed.

resultsThe study included 1382 patients (median age, 78 years, 52% men, 43% reduced ejection fraction) with a 5-year survival rate of 48% (95% CI, 46%-51%). The MRS included 9 metabolites measured. In the validation data set, a 1 standard deviation increase in the MRS was associated with a large increased rate of death (hazard ratio, 2.2 [95% CI, 1.9-2.5]) that remained after adjustment for Meta-Analysis Global Group in Chronic Heart Failure score and NT-proBNP (hazard ratio, 1.6 [95% CI, 1.3-1.9]). These associations did not differ by ejection fraction. The integrated discrimination and net reclassification indices, and Uno's C statistic, indicated that the addition of the MRS improved discrimination over Meta-Analysis Global Group in Chronic Heart Failure and NT-proBNP.

conclusionsThis MRS developed in a heart failure community cohort was associated with a large excess risk of death and improved risk stratification beyond an established risk score and clinical markers.

Indexed as

Heart FailureAgedBiomarkersCause of DeathChronic DiseaseFemaleHumansMalePrognosisRisk FactorsBiomarkersatrial fibrillationbiomarkerscardiovascular diseasesheart failurenatriuretic peptide, brain

Identifiers

PMID38516784
PMCPMC11021175
OpenAlexW4393093137

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.