Abstract P412: Toward A Biomarker Kit Suitable For Clinical Practice; A Novel Metabolomic Biomarker Risk Score Improves The Prognostic Value Of Cardiovascular Mortality In Elderly Congestive Heart Failure Patients

Aims: The Cardiac Lipid Panel (CLP) is a newly discovered panel of metabolite-based biomarkers that has previously shown to improve the diagnostic value of NT-proBNP. Little is known about its usefulness in predicting outcomes. In this study, the aim was to develop a risk score for 4-year cardiovascular death in elderly CHF patients. Methods and Results: We included 280 patients >65 years of age with CHF randomly selected from the CIBIS-ELD trial. A targeted metabolomic analysis of the three CLP biomarkers was performed on baseline serum samples. Cox proportional hazards regression was used to determine the relationship of the biomarkers with the outcome and adjusted for established risk factors (age, sex, BMI, creatinine, LDL, triglycerides, and LVEF). The CLP risk score was calculated by counting the number of biomarkers above a cut-off determined using the Youden’s indexes. During the follow-up period, mean 50 months [±8 months], 35 (18%) subjects met the primary endpoint of cardiovascular death. The area under the receiver operating curve (AUROC) for the model based on only clinical variables was 0.72, the second model with clinical variables plus NT-proBNP was 0.79, and the final model with clinical variables, NT-proBNP, plus the CLP was 0.83. Conclusions: A risk score based on a panel of 3 metabolite-based biomarkers was found to improve the prognostic value of traditional risk factors and NT-proBNP in a cohort of CHF subjects. Our next steps include validating the prognostic value of the CLP biomarker kit in order to provide a better clinical risk assessment of CHF patients.