Abstract
AimsThe 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 methodsMass 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 findingsDuring 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. SignificanceOur 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.
Published Version
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
