Free fatty acids: independent predictors of long-term adverse cardiovascular outcomes in heart failure patients

Autor: Guang-zhi Liao, Hui-hui Liu, Chun-hui He, Jia-yu Feng, Xiao-feng Zhuang, Jing-xi Wang, Ping Zhou, Yan Huang, Qiong Zhou, Mei Zhai, Yu-hui Zhang, Jian Zhang
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Lipids in Health and Disease, Vol 23, Iss 1, Pp 1-11 (2024)
Druh dokumentu: article
ISSN: 1476-511X
DOI: 10.1186/s12944-024-02332-5
Popis: Abstract Background The association between plasma free fatty acid (FFA) and the outcomes in the heart failure (HF) patients remains unclear. Methods A cohort study among HF patients was performed. Plasma FFA was analyzed as both a continuous and a categorical variable (grouped by tertiles) to assess its association with composite cardiovascular (CV) death and HF hospitalization (CV death & HHP), CV death alone, and all-cause mortality (ACM) using Cox regression models. Subgroup analyses of HF patients with preserved ejection fraction (HFpEF) and mildly reduced/reduced ejection fraction (HFmrEF/HFrEF) were performed. This work also assessed the effectiveness of combining FFA and NT-pro BNP biomarkers for risk stratification by calculating the concordance index (C-index). Results Among the 4,109 HF patients, FFA levels exceeding 0.4–0.42 mmol/L were associated with increased risks of the three outcomes. Patients in the highest FFA tertile faced greater risks than those in the lowest tertile. Adjusted hazard ratios were 1.32 (95% CI: 1.11–1.58) for CV death & HHP, 1.45 (95% CI: 1.16–1.82) for CV death, and 1.39 (95% CI: 1.15–1.68) for ACM, with a maximum follow-up of 8 years (median: 25 months). Subgroup analyses revealed that elevated FFA levels consistently predicted worse outcomes in both HFmrEF/HFrEF and HFpEF patients. The C-index for predicting outcomes was significantly greater when NT-pro BNP and FFA were combined than when NT-pro BNP was used alone (P
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