Xiaoyu Du1, Yulin Li2, Yuan Wang2, Hongzhao You2, Peng Hui3, Yang Zheng4, Jie Du5. 1. The First Hospital of Jilin University, Changchun 130021, China; Beijing Institute of Heart, Lung & Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, China. 2. Beijing Institute of Heart, Lung & Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, China. 3. The First Hospital of Jilin University, Changchun 130021, China. 4. The First Hospital of Jilin University, Changchun 130021, China. Electronic address: zhengyangjlu@163.com. 5. Beijing Institute of Heart, Lung & Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, China. Electronic address: dujieanzhen08@163.com.
Abstract
AIMS: The long-term prognosis of ST-segment elevation myocardial infarction (STEMI) with acute heart failure (AHF) is poor. Identification of metabolic changes could provide understanding of the underlying pathological progress associated with adverse events in patients with STEMI and AHF. Therefore, the study aimed to identify new plasm metabolites associated with long-term adverse cardiovascular events in patients with STEMI and AHF. MATERIALS AND METHODS: Mass spectrometry measurements of 26 amino acids were performed in 138 patients with STEMI and AHF. Endpoints were adverse cardiac events (composite of death and heart failure hospitalization). Survival analysis was performed to determine independent predictors of amino acids. KEY FINDINGS: During a 3-year follow-up, there were 32 deaths and 21 hospitalizations for heart failure (HF). Multivariable Cox regression analysis showed that branched-chain amino acid (BCAA) levels were independent predictors for adverse cardiovascular events in patients with STEMI and AHF (adjusted HR: 2.67, p < 0.001). The prognostic value of BCAA was better than that of N-terminal pro-B-type natriuretic peptide (area under the curve: 0.77 vs. 0.72) and Kaplan-Meier curves for adverse cardiac events (log-rank: 14.91 vs. 10.05). The combination of BCAAs and NT-proBNP yielded a stronger predictive value (area under the curve: 0.81, log-rank: 27.14). Importantly, addition of BCAAs and NT-pro BNP to the Global Registry of Acute Coronary Events score increased the C-statistic from 0.707 to 0.813, with a net reclassification improvement of 0.714. SIGNIFICANCE: Our study shows that increased plasma BCAA levels are associated with long-term adverse cardiovascular events in patients with STEMI and AHF. These findings suggest that dysregulated BCAA metabolism pathways affect clinical outcome after STEMI with AHF.
AIMS: The long-term prognosis of ST-segment elevation myocardial infarction (STEMI) with acute heart failure (AHF) is poor. Identification of metabolic changes could provide understanding of the underlying pathological progress associated with adverse events in patients with STEMI and AHF. Therefore, the study aimed to identify new plasm metabolites associated with long-term adverse cardiovascular events in patients with STEMI and AHF. MATERIALS AND METHODS: Mass spectrometry measurements of 26 amino acids were performed in 138 patients with STEMI and AHF. Endpoints were adverse cardiac events (composite of death and heart failure hospitalization). Survival analysis was performed to determine independent predictors of amino acids. KEY FINDINGS: During a 3-year follow-up, there were 32 deaths and 21 hospitalizations for heart failure (HF). Multivariable Cox regression analysis showed that branched-chain amino acid (BCAA) levels were independent predictors for adverse cardiovascular events in patients with STEMI and AHF (adjusted HR: 2.67, p < 0.001). The prognostic value of BCAA was better than that of N-terminal pro-B-type natriuretic peptide (area under the curve: 0.77 vs. 0.72) and Kaplan-Meier curves for adverse cardiac events (log-rank: 14.91 vs. 10.05). The combination of BCAAs and NT-proBNP yielded a stronger predictive value (area under the curve: 0.81, log-rank: 27.14). Importantly, addition of BCAAs and NT-pro BNP to the Global Registry of Acute Coronary Events score increased the C-statistic from 0.707 to 0.813, with a net reclassification improvement of 0.714. SIGNIFICANCE: Our study shows that increased plasma BCAA levels are associated with long-term adverse cardiovascular events in patients with STEMI and AHF. These findings suggest that dysregulated BCAA metabolism pathways affect clinical outcome after STEMI with AHF.
Authors: Raul Sanchez-Gimenez; Wahiba Ahmed-Khodja; Yesica Molina; Oscar M Peiró; Gil Bonet; Anna Carrasquer; George A Fragkiadakis; Mònica Bulló; Alfredo Bardaji; Christopher Papandreou Journal: Nutrients Date: 2022-06-27 Impact factor: 6.706
Authors: Dipsikha Biswas; Kathleen Tozer; Khoi T Dao; Lester J Perez; Angella Mercer; Amy Brown; Intekhab Hossain; Alexandra M Yip; Christie Aguiar; Hany Motawea; Keith R Brunt; Jennifer Shea; Jean F Legare; Ansar Hassan; Petra C Kienesberger; Thomas Pulinilkunnil Journal: Front Endocrinol (Lausanne) Date: 2020-08-07 Impact factor: 5.555