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Impact of diabetes on serum biomarkers in heart failure with preserved ejection fraction: insights from the TOPCAT trial
dc.contributor.authorDe Marco, Corrado
dc.contributor.authorClaggett, Brian L.
dc.contributor.authorDenus, Simon
dc.contributor.authorZile, Michael R.
dc.contributor.authorHuynh, Thao
dc.contributor.authorDesai, Akshay S.
dc.contributor.authorSirois, Martin G.
dc.contributor.authorSolomon, Scott D.
dc.contributor.authorPitt, Bertram
dc.contributor.authorRouleau, Jean L.
dc.contributor.authorPfeffer, Marc A.
dc.contributor.authorO’Meara, Eileen
dc.date.accessioned2021-04-06T02:10:14Z
dc.date.available2022-05-05 22:10:13en
dc.date.available2021-04-06T02:10:14Z
dc.date.issued2021-04
dc.identifier.citationDe Marco, Corrado; Claggett, Brian L.; Denus, Simon; Zile, Michael R.; Huynh, Thao; Desai, Akshay S.; Sirois, Martin G.; Solomon, Scott D.; Pitt, Bertram; Rouleau, Jean L.; Pfeffer, Marc A.; O’Meara, Eileen (2021). "Impact of diabetes on serum biomarkers in heart failure with preserved ejection fraction: insights from the TOPCAT trial." ESC Heart Failure 8(2): 1130-1138.
dc.identifier.issn2055-5822
dc.identifier.issn2055-5822
dc.identifier.urihttps://hdl.handle.net/2027.42/167031
dc.description.abstractAimsDiabetes mellitus (DM) is common in heart failure with preserved ejection fraction (HFpEF). Patients with DM and heart failure with reduced ejection fraction have higher levels of cardiac, profibrotic, and proinflammatory biomarkers relative to non‐diabetics. Limited data are available regarding the biomarker profiles of HFpEF patients with diabetes (DM) vs. no diabetes (non‐DM) and the impact of spironolactone on these biomarkers. This study aims to address such gaps in the literature.Methods and resultsBiomarkers were measured at randomization and at 12 months in 248 patients enrolled in Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist’s North American cohort. At baseline, DM patients had significantly lower estimated glomerular filtration rate and higher high‐sensitivity C‐reactive protein, pro‐collagen type III amino‐terminal peptide, tissue inhibitor of metalloproteinase 1 (TIMP‐1), and galectin‐3 levels than those without diabetes. There was a significantly larger 12 month increase in levels of high‐sensitivity troponin T (hs‐TnT), a marker of myocyte death, in DM patients. Elevated pro‐collagen type III amino‐terminal peptide and galectin‐3 levels were associated with an increased risk of the primary outcome (cardiovascular mortality, aborted cardiac arrest, or heart failure hospitalization) in DM patients, but not in those without diabetes. A statistically significant interaction between spironolactone and diabetes status was observed for hs‐TnT and for TIMP‐1, with greater biomarker reductions among those with diabetes treated with spironolactone.ConclusionsThe presence of diabetes is associated with higher levels of cardiac, profibrotic, and proinflammatory biomarkers in HFpEF. Spironolactone appears to alter the determinants of extracellular matrix remodelling in an anti‐fibrotic fashion in patients with diabetes, reflected by changes in hs‐TnT and TIMP‐1 levels over time.
dc.publisherWiley Periodicals, Inc.
dc.subject.otherPreserved left ventricular function
dc.subject.otherDiabetes
dc.subject.otherBiomarker
dc.subject.otherSpironolactone
dc.subject.otherHeart failure
dc.titleImpact of diabetes on serum biomarkers in heart failure with preserved ejection fraction: insights from the TOPCAT trial
dc.typeArticle
dc.rights.robotsIndexNoFollow
dc.subject.hlbsecondlevelCardiovascular Medicine
dc.subject.hlbtoplevelHealth Sciences
dc.description.peerreviewedPeer Reviewed
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/167031/1/ehf213153_am.pdf
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/167031/2/ehf213153.pdf
dc.identifier.doi10.1002/ehf2.13153
dc.identifier.sourceESC Heart Failure
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dc.working.doiNOen
dc.owningcollnameInterdisciplinary and Peer-Reviewed


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