Circulating acetoacetate is associated with poor prognosis in heart failure patients
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: This study enrolled consecutive 615 hospitalized patients with heart f...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2019-12-01
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| Series: | International Journal of Cardiology: Heart & Vasculature |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352906719301666 |
| _version_ | 1818306014037934080 |
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| author | Tetsuro Yokokawa Akiomi Yoshihisa Yuki Kanno Satoshi Abe Tomofumi Misaka Shinya Yamada Takashi Kaneshiro Takamasa Sato Masayoshi Oikawa Atsushi Kobayashi Kazuhiko Nakazato Takafumi Ishida Yasuchika Takeishi |
| author_facet | Tetsuro Yokokawa Akiomi Yoshihisa Yuki Kanno Satoshi Abe Tomofumi Misaka Shinya Yamada Takashi Kaneshiro Takamasa Sato Masayoshi Oikawa Atsushi Kobayashi Kazuhiko Nakazato Takafumi Ishida Yasuchika Takeishi |
| author_sort | Tetsuro Yokokawa |
| collection | DOAJ |
| description | 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: 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: 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: 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. Keywords: Acetoacetate, Ketone body, Metabolism, Heart failure, Prognosis |
| first_indexed | 2024-12-13T06:35:44Z |
| format | Article |
| id | doaj.art-8a3bff16b0894c18990a8d5b95b6809a |
| institution | Directory Open Access Journal |
| issn | 2352-9067 |
| language | English |
| last_indexed | 2024-12-13T06:35:44Z |
| publishDate | 2019-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology: Heart & Vasculature |
| spelling | doaj.art-8a3bff16b0894c18990a8d5b95b6809a2022-12-21T23:56:31ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672019-12-0125Circulating acetoacetate is associated with poor prognosis in heart failure patientsTetsuro Yokokawa0Akiomi Yoshihisa1Yuki Kanno2Satoshi Abe3Tomofumi Misaka4Shinya Yamada5Takashi Kaneshiro6Takamasa Sato7Masayoshi Oikawa8Atsushi Kobayashi9Kazuhiko Nakazato10Takafumi Ishida11Yasuchika Takeishi12Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan; Department of Pulmonary Hypertension, Fukushima Medical University, Fukushima, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan; Department of Advanced Cardiac Therapeutics, Fukushima Medical University, Fukushima, Japan; Corresponding author at: Department of Cardiovascular Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima 960-1295, Japan.Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan; Department of Advanced Cardiac Therapeutics, Fukushima Medical University, Fukushima, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima, JapanDepartment of Cardiovascular Medicine, Fukushima Medical University, Fukushima, JapanBackground: 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: 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: 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: 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. Keywords: Acetoacetate, Ketone body, Metabolism, Heart failure, Prognosishttp://www.sciencedirect.com/science/article/pii/S2352906719301666 |
| spellingShingle | Tetsuro Yokokawa Akiomi Yoshihisa Yuki Kanno Satoshi Abe Tomofumi Misaka Shinya Yamada Takashi Kaneshiro Takamasa Sato Masayoshi Oikawa Atsushi Kobayashi Kazuhiko Nakazato Takafumi Ishida Yasuchika Takeishi Circulating acetoacetate is associated with poor prognosis in heart failure patients International Journal of Cardiology: Heart & Vasculature |
| title | Circulating acetoacetate is associated with poor prognosis in heart failure patients |
| title_full | Circulating acetoacetate is associated with poor prognosis in heart failure patients |
| title_fullStr | Circulating acetoacetate is associated with poor prognosis in heart failure patients |
| title_full_unstemmed | Circulating acetoacetate is associated with poor prognosis in heart failure patients |
| title_short | Circulating acetoacetate is associated with poor prognosis in heart failure patients |
| title_sort | circulating acetoacetate is associated with poor prognosis in heart failure patients |
| url | http://www.sciencedirect.com/science/article/pii/S2352906719301666 |
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