Heart failure & cardiomyopathies
Integrating ketone bodies in multi-marker risk prediction of incident heart failure in the multi-ethnic study of atherosclerosis
Authors' conclusion
The addition of plasma KB to a clinical risk score using biomarkers of cardiac injury and stress may further improve the prediction of incident HF.
Study context
- Population
- Multi-Ethnic Study of Atherosclerosis participants without CVD383 incident heart failure (HF) events
- Participants
- 6,748 participants
- Exposure
- Multi-marker score with vs without total ketone bodies (KB) added to NT-proBNP and hs-cTnT
- Outcome
- Incident HF
- Follow-up
- Median 15.7 years
Methodological detailsrisk prediction analysis, multi-ethnic, community-based
- Risk prediction analysis
- Multi-ethnic
- Community-based
Main finding
As reported in the abstract
Incident HF risk prediction (C-statistic)
| Group | C-statistic, 5-year | C-statistic, 10-year |
|---|---|---|
| NT-proBNP + hs-cTnT + KB | 0.77 | 0.73 |
| NT-proBNP + hs-cTnT | 0.74 | 0.70 |
C-statistic, 5-year
NT-proBNP + hs-cTnT + KB0.77
NT-proBNP + hs-cTnT0.74
C-statistic, 10-year
NT-proBNP + hs-cTnT + KB0.73
NT-proBNP + hs-cTnT0.70
- NT-proBNP + hs-cTnT + KB vs NT-proBNP + hs-cTnT: P = 0.02 — 5-year: 0.74 vs. 0.77
- NT-proBNP + hs-cTnT + KB vs NT-proBNP + hs-cTnT: P = 0.02 — 10-year: 0.70 vs. 0.73
Observational data: associations, not effects.
Further findings
Correlation between the three biomarkers
- Poor correlation with one another
- r < 0.06 for all
Calibration of multi-marker score for 5- and 10-year HF risk
- No evidence of miscalibration
- P > 0.05
Multi-marker score and HF risk
- Graded association independent of established clinical factors
- Multivariable Cox model
Original publication
Integrating ketone bodies in multi-marker risk prediction of incident heart failure in the multi-ethnic study of atherosclerosis. Eur J Prev Cardiol. Published 21 March 2025. doi:10.
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