Stenemo M, et al. - Whether metabolomic profiling of blood can serve as an aid to better understand the pathogenesis of heart failure or to achieve a better risk prediction, was investigated in this study. Researchers used three community-based cohorts without heart failure at baseline (n = 3924; 341 incident heart failure events; the range of median follow-up was from 4.6 to 13.9 years) to perform metabolomic profiling. They found that circulating levels of urobilin (haem breakdown product) and sphingomyelin (30:1) (a cell membrane component involved in signal transduction and apoptosis) were related to incident heart failure. In the discovery and replication sample, an association of higher circulating urobilin and lower sphingomyelin (30:1) with incident heart failure were evident in age-adjusted and sex-adjusted models. The addition of top 2 metabolites or nine Lasso-selected metabolites to a modified Atherosclerosis Risk in Communities heart failure risk score model resulted in no major improvement in risk prediction.