Biomarker Predicts Heart Failure Patients at High Risk of Death

Patients with heart failure who have higher levels of neuropeptide Y, a molecule released by the nervous system, are ten times more likely to die within one to three years than patients with lower levels of neuropeptides, according to a study published in JAMA Cardiology.

Researchers from UCLA noted that about half of people who develop heart failure die within five years of being diagnosed. Healthcare professionals still don’t understand why some patients die sooner than others despite receiving the same medications and medical device therapy.

The team set out to determine whether a biomarker of the nervous system could help explain the difference. Researchers analyzed blood from 105 patients with stable heart failure, meaning those who have heart injury but do not require hospitalization. The group searched for a distinct biomarker in the blood that could predict how likely a person would be to die within a few years.

Researchers found that patients with higher levels of neuropeptide Y had worse outcomes than those that had lower levels of neuropeptide Y. The team also compared tissue samples from patients with samples from healthy donors and found that the neurons in people with the highest risk of dying were likely releasing the higher levels of neuropeptides.

These findings could help researchers advance precision medicine for people with heart failure, allowing them to treat patients according to their specific needs.

“The results could give scientists a way to distinguish very-high-risk patients with stable heart failure from others with the same condition, which could inform which patients might require more aggressive and targeted therapies. The study also highlights the need for heart failure therapies that target the nervous system,” researchers concluded.

“Further studies could help determine whether a patient’s risk for death can be ascertained through less invasive measures, such as a simple blood draw, and whether early aggressive intervention in these people could reduce their risk of death.”

This study isn’t the first time researchers have investigated ways to personalize heart failure care. A team from the Intermountain Medical Center Heart Institute developed a precision medicine approach that cut mortality rates for heart failure patients by 48 percent and 30-day hospital readmissions by 25 percent.

“Using new and unique approaches that deliver healthcare to heart failure patients based on the best information we have for their individual needs improves patient outcomes,” said Benjamin Horne, PhD, researcher with the Intermountain Medical Center Heart Institute and lead author of the study.

“Rather than providing standard treatment protocols to all patients, the study is helping us provide the necessary expanded level of care for patients who are at higher risk for hospital readmissions or death.”

In a recent scientific statement, the American Heart Association (AHA) also recently highlighted the significant role precision medicine could play in improving outcomes for heart failure patients. Using information about a patient’s genetic makeup, metabolism, and other biological and environmental factors can help providers decide what strategies will better treat or prevent the condition.

“Major clinical trials often treat large numbers of patients with one medication, and if there is a positive result, the use of that medication is likely to be incorporated into guidelines for treatment,” said Sharon Cresci, MD, chair of the statement writing group and associate professor of medicine and genetics at Washington University in St. Louis, Missouri.

“Yet, within the large group of clinical trial participants, there are often some with no response and some with an adverse response. Precision medicine approaches can help us identify who those non-responders or adverse responders are likely to be so we can find different treatment options for them.”

Through further research into heart failure and the makeup of patients with this condition, the industry can help target effective treatments and improve outcomes.

“The field of precision medicine is still in its infancy, with infrastructure and programs to be built. We’ll need specialized training for clinicians, processes for sharing information across large databases and guarantees for patient privacy,” Cresci said at the time. “It’s exciting to realize the potential life-saving innovations on the horizon through precision medicine.”