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Heart failure & cardiomyopathiesCohort study

Dephospho-Uncarboxylated Matrix Gla-Protein Is Associated With Adverse Outcomes in Heart Failure

Circ Heart FailPublished

  • cohort study
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Authors' conclusion

Higher dpucMGP is associated with multiple biological pathways and with an increased risk for adverse outcomes in HF. Greater dpucMGP levels mediated the relationship between warfarin use and adverse outcomes. Further studies are required to determine the role of therapeutic interventions to reduce dpucMGP levels in this patient population.

Study context

Population
Patients with heart failure, PHFS (Penn heart failure (HF) Study) participantsPHFS participants with plasma dpucMGP measured
Participants
2,247 patients
Exposure
Association between plasma dpucMGP levels and outcomes

Main finding

Death or HF-related hospital admission

Standardized hazard ratio

1.23

95% CI 1.17–1.28

P < 0.0001

Increased dpucMGP levels
standardized hazard ratio 1.23 (95% CI 1.17–1.28); P < 0.0001

As reported in the abstract

Observational data: associations, not effects.

Further findings

All-cause death

Comparisonstandardized hazard ratio (95% CI)P value
Increased dpucMGP levels · increased risk with increased dpucMGP1.32 (1.25–1.40)P < 0.0001

All-cause death

Associations particularly among participants with nonischemic HF

Participant characteristics

Median age
61 years (interquartile range, 53-70 years)
Male
64%
White
71%

Proteomic associations of dpucMGP

Prominent proteomic associations with acute phase response, coagulation, complement system, fibrosis, cell signaling, and metabolic pathways

Correlates of dpucMGP

Greater dpucMGP associated with older age, renal dysfunction, and warfarin use
Black ethnicity associated with lower dpucMGP

Mediation of the association between warfarin use and adverse outcomes by dpucMGP

Death, total effect
P = 0.005
Death, indirect effect
P < 0.001
Death or HF-related hospital admission, total effect
P < 0.001
Death or HF-related hospital admission, indirect effect
P = 0.002
  • Associations between dpucMGP and outcomes were dependent on warfarin use

Original publication

Dephospho-Uncarboxylated Matrix Gla-Protein Is Associated With Adverse Outcomes in Heart Failure. Circ Heart Fail. Published 28 January 2026. doi:10.1161/circheartfailure.124.012734
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Summarised from the published abstract; every number is checked against it