Circulating acetoacetate is associated with poor prognosis in heart failure patients.
Acetoacetate
Heart failure
Ketone body
Metabolism
Prognosis
Journal
International journal of cardiology. Heart & vasculature
ISSN: 2352-9067
Titre abrégé: Int J Cardiol Heart Vasc
Pays: Ireland
ID NLM: 101649525
Informations de publication
Date de publication:
Dec 2019
Dec 2019
Historique:
received:
16
07
2019
revised:
21
09
2019
accepted:
09
10
2019
entrez:
1
1
2020
pubmed:
1
1
2020
medline:
1
1
2020
Statut:
epublish
Résumé
Acetoacetate is used as an alternative energy source in the heart, and has the potential to improve cardiac function. However, the prognostic impact of acetoacetate has not been investigated in heart failure. This study enrolled consecutive 615 hospitalized patients with heart failure. We investigated the associations between circulating acetoacetate and clinical characteristics or prognosis in HF patients. We divided the patients into two groups based on circulating acetoacetate levels (high group: acetoacetate ≥35 µmoL/L, n = 313; and low group: acetoacetate <35 µmoL/L, n = 302). The high group had an older age (68 vs. 65 years, P = 0.003) and higher log brain natriuretic peptide levels (2.43 vs. 2.23, P < 0.001) compared with the low group. In contrast, there were no significant differences in the prevalence of co-morbidities, including diabetes mellitus, chronic kidney disease, and anemia, between the two groups. During the median follow-up period of 328 days, 66 all-cause deaths occurred. The high group had a worse prognosis compared with the low group (Log rank, P = 0.041). In the Cox proportional hazard analysis, circulating acetoacetate levels (per 10 µmoL/L increase) were associated with all-cause mortality (hazard ratio 1.020, 95% confidence interval 1.010-1.030, P < 0.001). Circulating acetoacetate is associated with all-cause mortality in patients with heart failure. These results provide new insights into the role of alternative cardiac metabolism in heart failure patients, and raise the possibility of acetoacetate as a novel biomarker to predict the prognosis of heart failure patients.
Sections du résumé
BACKGROUND
BACKGROUND
Acetoacetate is used as an alternative energy source in the heart, and has the potential to improve cardiac function. However, the prognostic impact of acetoacetate has not been investigated in heart failure.
METHODS
METHODS
This study enrolled consecutive 615 hospitalized patients with heart failure. We investigated the associations between circulating acetoacetate and clinical characteristics or prognosis in HF patients.
RESULTS
RESULTS
We divided the patients into two groups based on circulating acetoacetate levels (high group: acetoacetate ≥35 µmoL/L, n = 313; and low group: acetoacetate <35 µmoL/L, n = 302). The high group had an older age (68 vs. 65 years, P = 0.003) and higher log brain natriuretic peptide levels (2.43 vs. 2.23, P < 0.001) compared with the low group. In contrast, there were no significant differences in the prevalence of co-morbidities, including diabetes mellitus, chronic kidney disease, and anemia, between the two groups. During the median follow-up period of 328 days, 66 all-cause deaths occurred. The high group had a worse prognosis compared with the low group (Log rank, P = 0.041). In the Cox proportional hazard analysis, circulating acetoacetate levels (per 10 µmoL/L increase) were associated with all-cause mortality (hazard ratio 1.020, 95% confidence interval 1.010-1.030, P < 0.001).
CONCLUSIONS
CONCLUSIONS
Circulating acetoacetate is associated with all-cause mortality in patients with heart failure. These results provide new insights into the role of alternative cardiac metabolism in heart failure patients, and raise the possibility of acetoacetate as a novel biomarker to predict the prognosis of heart failure patients.
Identifiants
pubmed: 31890860
doi: 10.1016/j.ijcha.2019.100432
pii: S2352-9067(19)30166-6
pii: 100432
pmc: PMC6923508
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100432Informations de copyright
© 2019 The Authors.
Références
Circulation. 2017 Jan 17;135(3):224-240
pubmed: 27881564
J Cell Physiol. 2017 Dec;232(12):3296-3308
pubmed: 28059455
Circulation. 2016 Feb 23;133(8):706-16
pubmed: 26819374
Biochim Biophys Acta. 2008 Jul-Aug;1780(7-8):966-72
pubmed: 18439432
Am J Physiol. 1995 Jan;268(1 Pt 2):H441-7
pubmed: 7840294
JACC Heart Fail. 2016 Oct;4(10):808-815
pubmed: 27395350
Circ Heart Fail. 2017 Dec;10(12):null
pubmed: 29242353
Eur J Heart Fail. 2018 Feb;20(2):332-341
pubmed: 28990358
Free Radic Biol Med. 2016 Jun;95:268-77
pubmed: 27036365
Diabetes Care. 2016 Jul;39(7):1108-14
pubmed: 27289126
Tex Heart Inst J. 2011;38(5):533-8
pubmed: 22163128
Am J Physiol Heart Circ Physiol. 2003 Apr;284(4):H1340-7
pubmed: 12595283
J Neurosci Res. 2006 Mar;83(4):702-9
pubmed: 16435389
Int J Cardiol. 2016 Feb 1;204:112-3
pubmed: 26655553
Cardiovasc Res. 2011 May 1;90(2):251-7
pubmed: 21372005
J Am Coll Cardiol. 1996 Sep;28(3):665-72
pubmed: 8772754
N Engl J Med. 2015 Nov 26;373(22):2117-28
pubmed: 26378978
Circulation. 2013 Oct 15;128(16):e240-327
pubmed: 23741058
Circ J. 2016 Apr 25;80(5):1178-86
pubmed: 27026173
Nat Rev Endocrinol. 2016 Mar;12(3):144-53
pubmed: 26678809
Circ Res. 2016 May 13;118(10):1659-701
pubmed: 27012580
J Biol Chem. 2016 Jan 29;291(5):2181-95
pubmed: 26645687
J Am Heart Assoc. 2017 Oct 3;6(10):null
pubmed: 28974498
Pathophysiology. 2006 Aug;13(3):163-70
pubmed: 16782314
Circ Heart Fail. 2018 Dec;11(12):e004953
pubmed: 30562098
Curr Heart Fail Rep. 2016 Aug;13(4):166-71
pubmed: 27287200
J Lab Clin Med. 1997 Jan;129(1):72-80
pubmed: 9011593
Card Fail Rev. 2018 Aug;4(2):99-103
pubmed: 30206484
Circulation. 2016 Feb 23;133(8):698-705
pubmed: 26819376
PLoS One. 2016 Dec 28;11(12):e0168790
pubmed: 28030609
Diabetes. 1976 Sep;25(9):776-84
pubmed: 955305
Diabetes. 1999 Sep;48(9):1850-5
pubmed: 10480618
Circulation. 2007 Mar 27;115(12):1563-70
pubmed: 17353436