While we did not adjust for NT-proBNP in our models assessing the association between SLPI and incident HF given the high degree of missingness of NT-proBNP at Exam 1 or 2 (n = 1947), elevated natriuretic peptides may mediate the association between SLPI-related inflammation and HF given the strong positive relationship between SLPI and NT-proBNP in our study. Here, NPPB is linked to hydrops fetalis.