Serial measurements of 45 metabolic biomarkers via nuclear magnetic resonance (NMR) were analyzed longitudinally in two independent cohorts of patients with chronic heart failure (HF).
Higher levels of specific high-density lipoprotein (HDL) particles were associated with reduced risk of HF hospitalization, advanced HF therapy, or cardiovascular death, while larger HDL particle size was linked to increased risk.
Elevated triglyceride-rich lipoprotein particles and apolipoprotein A-I (ApoA-I) surprisingly correlated with lower adverse event rates, challenging traditional lipid risk paradigms in HF.
Inflammation and metabolic dysregulation biomarkers, including inflammation vulnerability index and metabolic vulnerability indices, were strong predictors of poor outcomes, underscoring systemic metabolic derangements in HF progression.
