In a study of 1032 participants in the Henry Ford Heart Failure Pharmacogenomic registry, MCACs and LCACs associated with ischemic etiology of HF and a prognostic metabolite profile comprising 13 metabolites, including C18:1, added incremental risk prediction for survival over N-terminal pro-B-type natriuretic peptide (NT-proBNP) over a median follow-up of almost 3 years (30). The gene discussed is NPPB; the disease is hydrops fetalis.