Heart failure & cardiomyopathiesCohort study
Circulating dipeptidyl peptidase 3 and outcomes in acute heart failure: an analysis of the STRONG-HF and CORTAHF studies
- Analyses were performed using two prospective acute heart failure (AHF) trials
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
Main finding
As reported in the abstract
Baseline characteristics, cDPP3 ≥ 40 ng/mL vs lower (STRONG-HF)
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)
| Comparison | OR (95% CI) | P value | |
|---|---|---|---|
| MRA use · independently associated with cDPP3 ≥ 40 ng/mL | 3.83 (1.47–9.96) | P = 0.006 | |
| non-Black ethnicity · lower odds of cDPP3 ≥ 40 ng/mL | 0.43 (0.29–0.64) | P < 0.0001 | |
| 0.10.31310Odds ratio (log scale) |
| Outcome | Values | Estimate | P value |
|---|---|---|---|
| Change in cDPP3 over 90 days | high-intensity care change −15% · usual care change −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:10.1093/eschf/xvag076
Summarised from the published abstract; every number is checked against it