Heart failure & cardiomyopathies
Circulating dipeptidyl peptidase 3 and outcomes in acute heart failure: an analysis of the STRONG-HF and CORTAHF studies
Authors' conclusion
In AHF, cDPP3 was mildly elevated and was not associated with clinical outcomes or congestion relief during GDMT optimization. Elevated cDPP3 identified a distinct clinical phenotype but did not confer adverse prognosis.
Study context
- Population
- Patients with acute heart failure (AHF) in the STRONG-HF and CORTAHF trialsSTRONG-HF patients with cDPP3 measured, 222 (23%) had cDPP3 ≥ 40 ng/mL
- Participants
- 973 patients
- Exposure
- Baseline cDPP3 ≥ 40 ng/mL vs lower concentrations
- cDPP3 ≥ 40 ng/mLn = 222
- Outcome
- Baseline characteristics, cDPP3 ≥ 40 ng/mL vs lower (STRONG-HF)
Main finding
As reported in the abstract
Female
Black
| Outcome | cDPP3 ≥ 40 ng/mL | cDPP3 < 40 ng/mL |
|---|---|---|
| Age | 58 ± 15 years | 65 ± 13 years |
- Lower NT-proBNP concentrations with cDPP3 ≥ 40 ng/mL
- P < 0.0001
Observational data: associations, not effects.
Further findings
Predictors of cDPP3 ≥ 40 ng/mL (pooled multivariable analysis)
| OR (95% CI) | P value | ||
|---|---|---|---|
| MRA useIndependently associated with cDPP3 ≥ 40 ng/mL | 3.83 (1.47–9.96) | P = 0.006 | |
| non-Black ethnicityLower odds of cDPP3 ≥ 40 ng/mL | 0.43 (0.29–0.64) | P < 0.0001 | |
| 0.10.31310Odds ratio (log scale) |
Change
| Outcome | High-intensity care | Usual care |
|---|---|---|
| Change in cDPP3 over 90 days | −15% | −8% |
- Change in cDPP3 over 90 days: P = .078
180-day outcomes by baseline cDPP3 ≥ 40 ng/mL (STRONG-HF)
- Baseline cDPP3 ≥ 40 ng/mL was not associated with 180-day outcomes
Association of changes in cDPP3 with NT-proBNP reduction
- Continuous
- P = 0.797
- ≥30% responder
- P = 0.990
Original publication
Circulating dipeptidyl peptidase 3 and outcomes in acute heart failure: an analysis of the STRONG-HF and CORTAHF studies. ESC Heart Fail. Published 16 March 2026. doi:10.
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