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Serum concentrations of free fatty acids are associated with 3-month mortality in acute heart failure patients.

ABSTRACT: Background Plasma free fatty acids (FFA) are higher in heart failure (HF) patients compared to healthy controls. Considering that the extent of FFA elevation in HF might mirror the severity of HF, we hypothesized that the serum levels of FFA may be a useful prognostic indicator for 3-month mortality in acute heart failure (AHF). Methods We analyzed the serum samples of AHF patients obtained at admission to the emergency department. Serum levels of FFA were analyzed using an enzymatic reagent on an automatic analyzer. Results Out of 152 included AHF patients that were originally included, serum samples of 132 patients were available for the quantification of FFA. Of these, 35 (26.5%) died within 3 months of onset of AHF. These patients had significantly higher serum levels of FFA compared to AHF patients who were alive 3 months after onset of AHF. Univariable logistic regression analyses showed a significant positive association of FFA levels with 3-month mortality (odds ratio [OR] 2.76 [95% confidence interval 1.32-6.27], p?=?0.010). Importantly, this association remained significant after adjusting for age and sex, as well as for further clinical and laboratory parameters that showed a significant association with 3-month mortality in the univariate analyses. Conclusions We conclude that the admission serum levels of FFA are associated with 3-month mortality in AHF patients. Therefore, measurements of circulating FFA levels may help identifying high-risk AHF patients.

SUBMITTER: Degoricija V

PROVIDER: S-EPMC6779572 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Serum concentrations of free fatty acids are associated with 3-month mortality in acute heart failure patients.

Degoricija Vesna V Trbušić Matias M Potočnjak Ines I Radulović Bojana B Pregartner Gudrun G Berghold Andrea A Scharnagl Hubert H Stojakovic Tatjana T Tiran Beate B Frank Saša S

Clinical chemistry and laboratory medicine 20191001 11

Background Plasma free fatty acids (FFA) are higher in heart failure (HF) patients compared to healthy controls. Considering that the extent of FFA elevation in HF might mirror the severity of HF, we hypothesized that the serum levels of FFA may be a useful prognostic indicator for 3-month mortality in acute heart failure (AHF). Methods We analyzed the serum samples of AHF patients obtained at admission to the emergency department. Serum levels of FFA were analyzed using an enzymatic reagent on ...[more]

PMID: 31188747

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Project description:Background: Perturbation of energy metabolism exacerbates cardiac dysfunction, serving as a potential therapeutic target in congestive heart failure. Although circulating free fatty acids (FFAs) are linked to insulin resistance and risk of coronary heart disease, it still remains unclear whether circulating FFAs are associated with the prognosis of patients with acute heart failure (AHF). Methods: This single-center, observational cohort study enrolled 183 AHF patients (de novo heart failure or decompensated chronic heart failure) in the Second Affiliated Hospital, Zhejiang University School of Medicine. All-cause mortality and heart failure (HF) rehospitalization within 1 year after discharge were investigated. Serum FFAs were modeled as quartiles as well as a continuous variable (per SD of FFAs). The restricted cubic splines and cox proportional hazards models were applied to evaluate the association between the serum FFAs level and all-cause mortality or HF rehospitalization. Results: During a 1-year follow-up, a total of 71 (38.8%) patients had all-cause mortality or HF rehospitalization. The levels of serum FFAs positively contributed to the risk of death or HF rehospitalization, which was not associated with the status of insulin resistance. When modeled with restricted cubic splines, the serum FFAs increased linearly for the incidence of death or HF rehospitalization. In a multivariable analysis adjusting for sex, age, body-mass index, coronary artery disease, diabetes mellitus, hypertension, left ventricular ejection fraction and N-terminal pro-brain natriuretic peptid, each SD (303.07 μmol/L) higher FFAs were associated with 26% higher risk of death or HF rehospitalization (95% confidence interval, 2-55%). Each increasing quartile of FFAs was associated with differentially elevated hazard ratios for death or HF rehospitalization of 1 (reference), 1.71 (95% confidence interval, [0.81, 3.62]), 1.41 (95% confidence interval, [0.64, 3.09]), and 3.18 (95% confidence interval, [1.53, 6.63]), respectively. Conclusion: Serum FFA levels at admission among patients with AHF were associated with an increased risk of adverse outcomes. Additional studies are needed to determine the causal-effect relationship between FFAs and acute cardiac dysfunction and whether FFAs could be a potential target for AHF management.

Project description:Trans fatty acids (TFAs) have been found to impair flow mediated vasodilation and nitric oxide (NO) production. We sought to examine if serum TFA levels are associated with plasma levels of the NO inhibitor asymmetric dimethylarginine (ADMA) and if possible relationships between serum TFA and cardiovascular morbidity or mortality are mediated or modified by plasma ADMA levels.The cohort included patients who underwent coronary angiography for suspected coronary heart disease in 2000-2001. Serum trans 16:1n7 and trans 18:1 isomers were determined by gas liquid chromatography and the summation of these two TFAs is reported as TFA (percentage by weight (wt%) or concentration). Associations between TFAs and ADMA were estimated by calculating the Spearman's rank correlation coefficient (?), and risk associations with AMI, cardiovascular death and all-cause mortality across quartiles of TFAs (wt% or concentration) were explored by Cox modeling.A total of 1364 patients (75 % men) with median (25(th),75(th) percentile) age 61 (54, 69) years, serum TFA 0.46 (0.36, 0.56) wt% and plasma ADMA 0.59 (0.50, 0.70) ?mol/L were studied. Serum TFA levels (? = 0.21, p < 0.001), trans 16:1n7 (? = 0.22, p < 0.001) and trans 18:1 (? = 0.20, p < 0.001) levels were significantly correlated with plasma ADMA levels. During the median (25(th),75(th) percentile) follow-up time of 5.8 (4.5, 6.4) years, 129 (9.5 %) patients experienced an AMI, 124 (9.1 %) died, whereof 66 (53 %) due to cardiovascular causes. After multivariate adjustments no significant associations between serum TFA levels (wt% or concentration) and incident AMI, CV death and all-cause mortality were observed. Similar results were obtained when repeating the analyses with trans 16:1n7 and trans 18:1 individually. Plasma ADMA levels did not significantly modify the associations between TFA levels and outcomes.Serum TFA levels were positively correlated with plasma ADMA levels. After multivariate adjustments, TFAs were not associated with incident AMI or mortality, and associations were not influenced by ADMA.Clinicaltrials.gov Identifier: NCT00354081.

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Serum concentrations of free fatty acids are associated with 3-month mortality in acute heart failure patients.

Publications

Serum concentrations of free fatty acids are associated with 3-month mortality in acute heart failure patients.

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