Biomarkers of renal dysfunction, endothelial dysfunction, and inflammation were associated with incident HFrEF. By contrast, only natriuretic peptides and UACR were associated with HFpEF. These findings highlight the need for future studies focused on identifying novel biomarkers of the risk of HFpEF.

Obesity and related cardiometabolic traits including insulin resistance are more strongly associated with risk of future HFpEF versus HFrEF. The differential risk of HFpEF with obesity seems particularly pronounced among women and may underlie sex differences in HF subtypes.

Competing interests Cornell University has filed a provisional patent application that covers the use of DUSP26 inhibitors for the treatment of type 2 diabetes. (US patent application no. 62/740744; N.G.-B. and J.C.L.). V.B. is currently an employee of Fractyl Laboratories Inc. and all analyses were conducted during employment at Massachusetts General Hospital.

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