Neurofilament Light and phosphorylated Tau-217 are associated with all-cause mortality in acute heart failure patients
A Yaghoubi, S H S Janelidze, J M J Molvin, A J A Jujic, O H O Hansson, M M M MagnussonAbstract
Background
Cognitive impairment (CI) is common in heart failure (HF) and associated with increased mortality and morbidity. Phosphorylated Tau-217 (p-tau217) and Neurofilament light (NfL) are biomarkers that have been shown to predict cognitive decline but their prognostic value for mortality and rehospitalization in HF patients has not been established.
Aims
To investigate whether p-tau217 and NfL are associated with all-cause mortality and rehospitalization in HF patients.
Method
In 491 patients hospitalized for HF with complete biomarker and covariate; associations between biomarkers and all-cause mortality and rehospitalization for HF were analyzed using Cox proportional hazards models. Models were adjusted for age, sex, BMI, systolic blood pressure and smoking status.
Results
The median age was 76 years (IQR 67-83) and 31 % were female. 355 deaths occurred during follow-up with a median follow up time of 3.6 years (IQR 1.2 - 6.6). In unadjusted Cox-regression analysis higher levels of p-tau217 and NfL were associated with increased all-cause mortality (HR 1.74 (95% CI = 1.43 – 2.12) and HR 2.27 (95% CI = 1.97 – 2.61), respectively). Associations remained significant after adjustment for both p-tau217 and NfL (HR 1.36 (95% CI 1.09 – 1.69) and HR 1.78 (95% CI = 1.50 – 2.11), respectively). Neither biomarker was significantly associated with HF rehospitalization.
Conclusion
In patients hospitalized for HF, higher levels of both p-tau217 and NfL were independently associated with all cause-mortality but not with HF rehospitalization. NfL demonstrated a stronger association compared to p-tau217, across all models. These findings suggest that p-tau217 and NfL may provide prognostic information beyond traditional risk factors and biomarkers in HF.