PSUN156 Circulating thrombospondin-2 level as a novel biomarker of heart failure in type 2 diabetes

INTRODUCTION: Circulating thrombospondin-2 (TSP2) has been associated with adverse cardiovascular outcomes in patients with heart failure (HF). Type 2 diabetes (T2D) increases HF risk and induces TSP2 tissue expression. Here, we investigated prospectively the role of circulating TSP2 as a novel biomarker of incident HF hospitalization (HHF), and its associations with longitudinal changes of echocardiographic parameters in T2D. METHODS: Baseline serum TSP2 level was measured in 4949 T2D patients from the Hong Kong West Diabetes Registry to determine its association with incident HHF using multivariable Cox regression analysis. In the echocardiographic study, baseline serum TSP2 level was measured in another 146 T2D patients without cardiovascular diseases who underwent detailed transthoracic echocardiography at baseline and after 1 year. RESULTS: Over a median follow-up of 7.8 years, 330 of 4949 patients (6.7%) developed incident HHF. Baseline serum TSP2 level was independently associated with the development of HHF (HR 1.31, 95%CI 1.06–1.62, p=0.014) after adjustments for conventional cardiovascular risk factors, atrial fibrillation, estimated glomerular filtration rate, albuminuria and high-sensitivity C-reactive protein level at baseline, as well as use of medications including angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, frusemide, aspirin, insulin, metformin and sodium-glucose co-transporter 2 inhibitors. In the echocardiographic study, baseline serum TSP2 level was independently associated with increase in average E/e' and left atrial volume index (p=0.04 and <0.01, respectively). CONCLUSION: Serum TSP2 level was independently associated with both incident HHF and deterioration in diastolic function in T2D, suggesting its potential to be developed as a novel HF biomarker in T2D. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.