Evidence mapPaperPMID 40504107Full record

ArticleESC heart failure2025

Proteins associated with rehospitalization, mortality and diuretic resistance in acutely decompensated heart failure.

Kenneth T Hubbell, Veena S Rao, Rebecca Scherzer, Michael G Shlipak, Juan B Ivery-Miranda, Nisha Bansal, Zachary L Cox, Jeffrey M Testani, Michelle M Estrella

Abstract read
In one paragraph

Article in ESC heart failure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
field-weighted citation impact
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

7 citing papers in PubMed.

  1. Article
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  3. Observational
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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

9 authors.

Kenneth T HubbellDepartment of Medicine and Kidney Health Research Collaborative, University of California, San Francisco, California, USA.
Veena S RaoBiomarker Assay Laboratory, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.
Rebecca ScherzerBiostatistics Core, Kidney Health Research Collaborative, University of California, San Francisco, California, USA.
Michael G ShlipakDivision of General Internal Medicine, Department of Medicine; and Kidney Health Research Collaborative, University of California, San Francisco, California, USA.
Juan B Ivery-MirandaInstituto Mexicano del Seguro Social, Hospital de Cardiologia, Mexico City, Mexico.
Nisha BansalDepartment of Medicine, University of Washington School of Medicine, Seattle, WA, USA.
Zachary L CoxDepartment of Pharmacy Practice, Lipscomb University College of Pharmacy, Nashville, TN, USA.
Jeffrey M TestaniSection of Cardiovascular Medicine, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.
Michelle M EstrellaDivision of Nephrology, Department of Medicine, Kidney Health Research Collaborative, University of California, San Francisco, California, USA.ORCID https://orcid.org/0000-0002-8902-9576

Funding

Advanced Kidney Health Monitoring in Persons Hospitalized with Heart FailureR01DK130870 · NORTHERN CALIFORNIA INSTITUTE/RES/EDU · 2025 to 2025
$673k
Mentored research in the intersection of kidney and cardiovascular diseaseK26DK138333 · UNIVERSITY OF WASHINGTON · 2025 to 2025
$110k
NCATS NIH HHS UL1 TR000142NHLBI NIH HHS R01 HL128973NIDDK NIH HHS K26 DK138333NIDDK NIH HHS P30 DK079310NIDDK NIH HHS P30DK079310NIDDK NIH HHS R01 DK121800NIDDK NIH HHS R01 DK130870NIH/NIDDK 1R01DK130870NIH/NIDDK R01HL128973
6 · The paper itself

Abstract

aimsMost proteomic analyses in patients with heart failure (HF) focus on the stable ambulatory setting; pathways that drive acute decompensated heart failure (ADHF) are largely uncharacterized. We aimed to examine the associations of cardiometabolic proteins with HF rehospitalization, mortality and diuretic response in patients with ADHF.

methodsThe Mechanisms of Diuretic Resistance Cohort comprised patients hospitalized for ADHF at Yale New Haven Hospital from 2015 to 2020. We quantified 369 serum proteins and evaluated their associations with rehospitalization, mortality or diuretic response, using individual and combined biomarkers. Models adjusted for sociodemographic/lifestyle factors, comorbidities and clinical factors. For individual biomarker models, significant proteins were those with a false-discovery rate q-value (FDRq) <1%, while combined biomarker models used a penalized cross-validated log-likelihood method to reduce false positives.

resultsOf 401 patients enrolled, median age was 65 years; 36% were female. Six (C1QTNF1, CTSD, FCN2, SERPINA12, TFRC and TNFRSF10C) were associated with increased risk of HF rehospitalization [hazard ratio (HR) ranging from 1.2 to 1.35 per standard deviation (SD) protein concentration] while one (SDC1) was associated with decreased risk (HR = 0.77 per SD protein concentration). Three (CDH1, FABP6 and TNC) were associated with mortality (HR ranging from 1.35 to 1.64 per SD protein concentration). Three (MMP7, PGLYRP1 and REN) were associated with reduced diuretic response (% Estimate ranging from -12.2% to -18.6% per SD protein concentration). Among all proteins, those associated with lower diuretic response correlated with greater mortality risk [Spearman r = -0.63 (95% confidence interval: -0.56, -0.69)].

conclusionsSeveral proteins with known associations with cardiometabolic disease were associated with poor outcomes or reduced diuretic response. They have known roles in inflammatory, metabolic and cardiac or kidney remodelling pathways and may point to novel pathways in ADHF that warrant investigation as potential prognostic tools and targets for intervention.

Indexed as

DiureticsDrug ResistanceHeart FailurePatient ReadmissionAcute DiseaseAgedBiomarkersFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisProteomicsRetrospective StudiesSurvival RateBiomarkersDiureticsheart failurekidney diseaseproteomics

Identifiers

PMID40504107
PMCPMC12450773

What Socratic holds

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Registered trials

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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.