Prognostic value of cartilage intermediate layer protein 1 in chronic heart failure

AIMS: Emerging evidence suggests that cartilage intermediate layer protein 1 (CILP‐1) is associated with myocardial remodelling. However, the prognostic value of circulating CILP‐1 in patients with heart failure (HF) remains to be elucidated. This study aimed to investigate whether circulating CILP‐1 can independently predict the outcome of chronic HF. METHODS AND RESULTS: This prospective cohort study included 210 patients with chronic HF and left ventricular ejection fraction <50% between September 2018 and December 2019. The primary endpoint was 1 year all‐cause mortality. During the 1 year follow‐up, 28 patients died. In multivariable Cox proportional hazards regression analysis, higher CILP‐1 levels were independently associated with a higher risk of mortality after adjusting for potential confounding factors. In Kaplan–Meier analysis, patients with CILP‐1 levels above the median had a significantly higher mortality rate than those with CILP‐1 levels below the median (log‐rank P = 0.015). In addition, CILP‐1 significantly improved prognostic prediction over N‐terminal pro‐brain natriuretic peptide by an increase in net reclassification improvement (P = 0.043) and a trend towards an increase in integrated discrimination improvement (P = 0.118). CONCLUSIONS: Circulating CILP‐1 is a novel independent prognostic predictor in chronic HF.