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Comment & Response
September 2018

High-Sensitivity Troponin and Heart Failure With Preserved Ejection Fraction—Balancing P Values With Prior Knowledge and Common Sense

Author Affiliations
  • 1Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
JAMA Cardiol. 2018;3(9):892. doi:10.1001/jamacardio.2018.1620

To the Editor de Boer et al1 use data from the international collaboration on heart failure subtypes, a pooled analysis of 4 prospective cohorts consisting primarily of adults without prior cardiovascular disease, to test the associations of 12 cardiovascular biomarkers with incident heart failure with both preserved ejection fraction (HFpEF) and reduced ejection fraction (HFrEF). Their analysis is comprehensive; however, they only had biomarker data from 1 point in time. They found that 6 biomarkers were associated with incident HFrEF, including natriuretic peptides and high-sensitivity troponin. In contrast, as highlighted in their conclusions, they found that “only natriuretic peptides and UACR [urinary albumin to creatinine ratio] were associated with HFpEF.”1 The authors call for future studies focused on identifying novel biomarkers of HFpEF.

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