Higher urine DP levels were associated with worse clinical outcomes in patients with HFrEF. The findings were reported in Circulation, based on a prespecified analysis of the GALACTIC-HF trial assessing baseline DP and prognosis. GALACTIC-HF was a randomized, double-blind, multicenter trial that evaluated OM versus placebo in 8,232 adults with HFrEF. Baseline DP data were available for 7,790 patients categorized as negative or trace (75.9%), 1+ (12.8%), and ≥2+ (11.4%). Patients with ≥2+ DP were younger and more often had New York Heart Association (NYHA) class III or IV status, diabetes, higher systolic blood pressure, and lower eGFR.

Primary event rates increased progressively across DP categories, reported per 100 person-years as 21.8 for negative or trace, 34.8 for 1+, and 38.1 for ≥2+. Similar trends were observed for the components of the primary outcome and for all-cause mortality. Although hazard ratios were partially attenuated after adjustment for recognized prognostic variables, including NT-proBNP and eGFR, higher DP remained significantly associated with clinical deterioration. The clinical effect of OM compared with placebo was not modified by DP category.

DP testing represents a simple and inexpensive marker with prognostic value in HFrEF. Its ability to identify individuals with higher risk supports its clinical relevance within routine evaluation.