Improving the Care of Heart Failure Patients Using the CASABLANCA Study

Nasrien Ibrahim, MD, cardiologist in the Advanced Heart Failure and Transplant Program within the Division of Cardiology, discusses her work in identifying patients who are at risk for developing heart failure. She and her research team are using the CASABLANCA database, which includes 1,000 patients referred to the Cardiac Catheterization Lab, to find biomarkers that could predict a patient's risk for heart failure. So far, the team has found that endothelin-1 can identify patients who are at risk, which may allow for early interventions to manage cardiovascular risk factors.

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Transcript

We've had several studies published from the CASABLANCA database including work that we're currently doing with KIM-1 and its ability to predict acute renal failure. Endothelin-1, which predicts incident heart failure, incident cardiovascular death, mortality, and we've also worked on several projects looking at aortic stenosis and how we can predict it with biomarkers using this large database.

The CASABLANCA database is a huge database of over 1,000 patients that were referred to the cath lab for coronary and peripheral angiographic procedures. Patients were referred to the cath lab for acute and nonacute indications including STEMIs, including abnormal stress tests, and we drew blood before the procedure. We also drew blood immediately after the procedure. The blood samples were analyzed for several biomarkers. We also collected data on baseline demographics, comorbidities. And so it's a huge database and it offers us the opportunity to analyze several biomarkers and understand their effects or their predictability on cardiovascular outcomes.

My research team and I are working on several project aimed at identifying patients that are at risk for development of heart failure. So in the study that we did this year, we looked at endothelin-1 in patients undergoing coronary peripheral angiography and whether endothelin-1 can predict cardiac outcomes. We found that it was highly predictive of incident heart failure, incident MI, cardiovascular death and all cause mortality. With my interest in heart failure, I was very pleased with the results because a simple biomarker such as endothelin-1 is able to identify patients to us that are at high risk of developing heart failure and gives us the chance to intervene earlier in terms of controlling diabetes, controlling hyperlipidemia and other cardiovascular risk factors in order to prevent future risk of the development of heart failure.

Refer a patient to the Mass General Heart Center

Learn more about the Heart Failure and Cardiac Transplant Program