Increased Plasma Pyruvate Kinase M2 (PK‐M2) in Heart Failure: A Novel Biomarker Related to Cardiac Function and its Clinical Implications

Background The purpose of this study was to investigate whether circulating pyruvate kinase M2 (PK‐M2) levels are elevated in the peripheral blood and to assess their association with diagnosis and prognosis in patients with heart failure (HF). Methods and Results We conducted a prospective investig...

Full description

Saved in:
Bibliographic Details
Main Authors: Lu Cao, Xiaoyu Dong, Fuzhong Chen, Guangjuan Li, Jiale Fang, Zhijun Han, Junhong Wang
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
Subjects:
Online Access:https://www.ahajournals.org/doi/10.1161/JAHA.124.036170
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850123450774978560
author Lu Cao
Xiaoyu Dong
Fuzhong Chen
Guangjuan Li
Jiale Fang
Zhijun Han
Junhong Wang
author_facet Lu Cao
Xiaoyu Dong
Fuzhong Chen
Guangjuan Li
Jiale Fang
Zhijun Han
Junhong Wang
author_sort Lu Cao
collection DOAJ
description Background The purpose of this study was to investigate whether circulating pyruvate kinase M2 (PK‐M2) levels are elevated in the peripheral blood and to assess their association with diagnosis and prognosis in patients with heart failure (HF). Methods and Results We conducted a prospective investigation involving 222 patients with HF and 103 control subjects, measuring PK‐M2 concentrations using ELISA. The primary outcome, assessed over a median follow‐up of 2 years (interquartile range: 776 to 926 days), was the time to the first occurrence of either rehospitalization for worsening HF or cardiovascular death. Patients with HF had higher PK‐M2 levels than controls (17.4±4.1 versus 7.8±2.3 U/mL, P <0.001), and these levels correlated with HF severity (New York Heart Association cardiac function class). Patients with reduced left ventricular ejection fraction had higher PK‐M2 concentrations than those with preserved ejection fraction (18.3±4.5 versus 16.7±3.6 U/mL, P <0.01). In a subset of patients with HF (n=52), PK‐M2 levels significantly decreased following standardized HF treatment (mean difference, −4.3±0.5 U/mL, P <0.001). A high PK‐M2 level had a 1.913‐fold higher risk of the primary outcome (P=0.033) after adjusting for multiple cardiovascular risk factors, but not with cardiovascular death. Additionally, PK‐M2 added incremental prognostic value beyond clinical predictors and N‐terminal pro‐brain natriuretic peptide (P <0.05). Conclusions Elevated PK‐M2 levels are associated with primary outcomes and rehospitalization for worsening heart failure in patients with HF. These findings suggest that PK‐M2 is a potential biomarker for HF diagnosis and prognosis, warranting consideration for serial patient assessment.
format Article
id doaj-art-9cbaca9bed1845ff981490b5b666f8b9
institution OA Journals
issn 2047-9980
language English
publishDate 2025-01-01
publisher Wiley
record_format Article
series Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
spelling doaj-art-9cbaca9bed1845ff981490b5b666f8b92025-08-20T02:34:35ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-01-0114210.1161/JAHA.124.036170Increased Plasma Pyruvate Kinase M2 (PK‐M2) in Heart Failure: A Novel Biomarker Related to Cardiac Function and its Clinical ImplicationsLu Cao0Xiaoyu Dong1Fuzhong Chen2Guangjuan Li3Jiale Fang4Zhijun Han5Junhong Wang6Department of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing ChinaDepartment of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing ChinaDepartment of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing ChinaDepartment of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing ChinaDepartment of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing ChinaDepartment of Clincal Research Center Jiangnan University Medical Center Wuxi Jiangsu Province ChinaDepartment of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing ChinaBackground The purpose of this study was to investigate whether circulating pyruvate kinase M2 (PK‐M2) levels are elevated in the peripheral blood and to assess their association with diagnosis and prognosis in patients with heart failure (HF). Methods and Results We conducted a prospective investigation involving 222 patients with HF and 103 control subjects, measuring PK‐M2 concentrations using ELISA. The primary outcome, assessed over a median follow‐up of 2 years (interquartile range: 776 to 926 days), was the time to the first occurrence of either rehospitalization for worsening HF or cardiovascular death. Patients with HF had higher PK‐M2 levels than controls (17.4±4.1 versus 7.8±2.3 U/mL, P <0.001), and these levels correlated with HF severity (New York Heart Association cardiac function class). Patients with reduced left ventricular ejection fraction had higher PK‐M2 concentrations than those with preserved ejection fraction (18.3±4.5 versus 16.7±3.6 U/mL, P <0.01). In a subset of patients with HF (n=52), PK‐M2 levels significantly decreased following standardized HF treatment (mean difference, −4.3±0.5 U/mL, P <0.001). A high PK‐M2 level had a 1.913‐fold higher risk of the primary outcome (P=0.033) after adjusting for multiple cardiovascular risk factors, but not with cardiovascular death. Additionally, PK‐M2 added incremental prognostic value beyond clinical predictors and N‐terminal pro‐brain natriuretic peptide (P <0.05). Conclusions Elevated PK‐M2 levels are associated with primary outcomes and rehospitalization for worsening heart failure in patients with HF. These findings suggest that PK‐M2 is a potential biomarker for HF diagnosis and prognosis, warranting consideration for serial patient assessment.https://www.ahajournals.org/doi/10.1161/JAHA.124.036170biomarkerheart failurepyruvate kinase M2short‐term prognosis
spellingShingle Lu Cao
Xiaoyu Dong
Fuzhong Chen
Guangjuan Li
Jiale Fang
Zhijun Han
Junhong Wang
Increased Plasma Pyruvate Kinase M2 (PK‐M2) in Heart Failure: A Novel Biomarker Related to Cardiac Function and its Clinical Implications
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
biomarker
heart failure
pyruvate kinase M2
short‐term prognosis
title Increased Plasma Pyruvate Kinase M2 (PK‐M2) in Heart Failure: A Novel Biomarker Related to Cardiac Function and its Clinical Implications
title_full Increased Plasma Pyruvate Kinase M2 (PK‐M2) in Heart Failure: A Novel Biomarker Related to Cardiac Function and its Clinical Implications
title_fullStr Increased Plasma Pyruvate Kinase M2 (PK‐M2) in Heart Failure: A Novel Biomarker Related to Cardiac Function and its Clinical Implications
title_full_unstemmed Increased Plasma Pyruvate Kinase M2 (PK‐M2) in Heart Failure: A Novel Biomarker Related to Cardiac Function and its Clinical Implications
title_short Increased Plasma Pyruvate Kinase M2 (PK‐M2) in Heart Failure: A Novel Biomarker Related to Cardiac Function and its Clinical Implications
title_sort increased plasma pyruvate kinase m2 pk m2 in heart failure a novel biomarker related to cardiac function and its clinical implications
topic biomarker
heart failure
pyruvate kinase M2
short‐term prognosis
url https://www.ahajournals.org/doi/10.1161/JAHA.124.036170
work_keys_str_mv AT lucao increasedplasmapyruvatekinasem2pkm2inheartfailureanovelbiomarkerrelatedtocardiacfunctionanditsclinicalimplications
AT xiaoyudong increasedplasmapyruvatekinasem2pkm2inheartfailureanovelbiomarkerrelatedtocardiacfunctionanditsclinicalimplications
AT fuzhongchen increasedplasmapyruvatekinasem2pkm2inheartfailureanovelbiomarkerrelatedtocardiacfunctionanditsclinicalimplications
AT guangjuanli increasedplasmapyruvatekinasem2pkm2inheartfailureanovelbiomarkerrelatedtocardiacfunctionanditsclinicalimplications
AT jialefang increasedplasmapyruvatekinasem2pkm2inheartfailureanovelbiomarkerrelatedtocardiacfunctionanditsclinicalimplications
AT zhijunhan increasedplasmapyruvatekinasem2pkm2inheartfailureanovelbiomarkerrelatedtocardiacfunctionanditsclinicalimplications
AT junhongwang increasedplasmapyruvatekinasem2pkm2inheartfailureanovelbiomarkerrelatedtocardiacfunctionanditsclinicalimplications