KANNAPOLIS — A local repository has helped move a study forward on a marker that could determine the possibility of future heart failure by providing additional samples in a timely manner.

Samples and data from the MURDOCK Study helped to accelerate a recent heart failure discovery by Duke University researchers. The MURDOCK Study Community Registry and Biorepository is a groundbreaking 12,526-participant community-based longitudinal cohort recruited from a 20-zip code region including Kannapolis and Cabarrus County. MURDOCK is an acronym that stands for Measurement to Understand Reclassification of Disease Of Cabarrus and Kannapolis.

A Duke Pathology research team in Durham has been working to determine that serum pro‐N‐cadherin is an early marker for heart failure. The discovery has the potential to identify patients who would benefit from intervention before they show signs of disease, as reported in the Journal of the American Heart Association. The team, led by Dr. Salvatore Vincent Pizzo,  used biospecimens and more than 13 years of corresponding data from 690 MURDOCK Study participants in the research.

The Duke Clinical and Translational Science Institute (CTSI) is making thousands of biospecimens and associated clinical outcomes data available to all Duke researchers through the MURDOCK Biorepository Transformation Initiative. Duke Kannapolis is part of the CTSI and directed by Dr. Svati H. Shah.

“The demographics and outcomes of the participants over time is critical, and that is what sets MURDOCK apart from other biorepositories,” said Paul Ferrell, who manages Pizzo’s lab and quantified the new biomarker. “We would not have been able to correlate the biomarker with any meaning if we didn’t have that downstream outcome data.”

About a year ago, preliminary research indicated the protein could be a marker for heart failure. Pizzo’s team needed to expand their study and reached out to Duke Kannapolis, hoping to accelerate their research by tapping into the MURDOCK biorepository.

“Our goal was to understand the role of the biomarker effectively and rigorously without waiting a decade for a new, prospective study to accumulate years of data,” Pizzo said. “MURDOCK already had thousands of samples and years of follow-up, saving us an incredible amount of time while delivering the same level of rigorous data collection. The responsiveness of Duke Kannapolis saved us even more time.”

Total time from initial contact to the conclusion of the study was six months. By comparison, requesting and receiving samples from other biorepositories can take up to two years.

“MURDOCK has been the springboard,” said Kristi Oristian, the postdoctoral research consultant on the team. “We asked a question about the predictive nature of how something might work in the future, but we answered it using previously collected samples and data showing how health has changed over time, thanks to MURDOCK participants who had been completing annual follow-up for years.” 

With the publication of the discovery, the research has drawn interest from collaborators and venture capitalists. The team’s next steps include repeating their initial findings in a different population, with additional techniques and a clinical approach.

Ultimately, they want to bring the biomarker to market and see it used in clinics and hospitals. The test for the biomarker is easy to administer and easy to understand, reducing the reliance on specialized equipment or expertise.

“Right now, there is no established community screening for heart failure,” Oristian said. “There are biomarkers that catch it at a later stage, but we are talking about detection well before people start to show symptoms.”

Duke Kannapolis provided Pizzo’s team with samples and data from two groups of MURDOCK Study participants. The participants all reported no heart failure when they enrolled in MURDOCK, and both groups had similar comorbidities and demographics. The participants who eventually suffered heart failure had the elevated biomarker. Those who never developed heart failure did not.

“It’s really important for us to see that against a background of common American comorbidities like high blood pressure and obesity, the biomarker was able to add additional predictive value to identify the folks who would develop heart failure,” Oristian said.

Using such closely matched cohorts provided more evidence that the biomarker is an independent predictor of heart failure, Ferrell added.

“They have such a large amount of MURDOCK data and samples that they were able to match the cohort of people who did not develop heart failure with those who did,” Ferrell said. “That was a lot of the difficult work that Duke Kannapolis completed and then provided to us.”

As part of the Duke Clinical and Translational Science Institute (CTSI), Duke Kannapolis manages a wide variety of research projects focusing on the exploration, discovery, and validation of biomarkers that will inform a deeper understanding of health and disease. Founded in 2007, Duke Kannapolis has enrolled nearly 14,000 participants using a successful community-engaged research model and is located on the North Carolina Research Campus.