engleski

Lipids and inflammatory markers in acute heart failure patients with metabolic syndrome

Purpose: Heart failure (HF) is an abnormality of cardiac structure or function lesion leading to failure of the heart to deliver oxygen at a rate commensurate with the requirements of the metabolizing tissues, despite normal filling pressures. Metabolic syndrome (MS) is present at 35% of patients (pts) with acute HF (AHF). MS is major concomitance in HF thus its pathogenesis pathways are among emphasized areas to investigate. The aim of this study was to investigate concommitance of MS and AHF with emphasised relationship between lipids and biomarkers. Methods: Study was performed as observational, prospective study on AHF pts recruited from the Emergency Department (ED) from January 2014 to January 2015. Participants were divided in two groups depending on presence of MS and compared according to levels of lipids and biomarkers. Pts were treated by standard protocol for AHF by ESC Guidelines. Study was approved by local Ethics committee. Written informed consent was obtained from each pt according to Good Clinical Practice and Helsinki Declaration principles. Pts’ history, clinical presentation, diagnostic procedures and laboratory tests were recorded. Results: Analysis included data for 100 pts presenting with AHF admitted in the ED and hospitalized. Interestingly there were 53% female pts and 47% male, average age 73 years. Most common clinical presentation of AHF was acute worsening of chronic HF. Unexpectedly, 90% of pts had high (III or IV) New York Heart Association (NYHA) Functional Classification. Increased BMI was observed for 70% of pts, 40% were classified as obese with BMI >30 kg/m2, 23 of them were male. It was observed that 89% pts had hypertension, 54% diabetes mellitus, 42% hypercholesterolaemia, 40% hyperlipidaemia and 30% anemia. Family history of cardiovascular disease had 48% of pts and 26% were smokers. Remarkably, 59% of investigated pts had MS, equally by gender. Average cholesterol level was 4.11 (mmol/L), 4.12 for pts with MS, 4.08 for pts without MS. Average HDL level for pts with MS was 0.943, 1.05 for patients without MS, average triglyceride level was 1.22 (mmol/L), 1.33 for pts with MS, 1.05 for pts without MS. 30-day mortality was 15%. Clinical improvement was most common recorded outcome. Conclusions: MS is important concomitant factor in development of AHF. It was detected in 59% of hospitalized pts. Excitingly, pts in our study had highly elevated BMI, NYHA score and overlapping MS. The results of this research offer MS as treatment focus for improving outcome of AHF pts. It is obligatory to provide further research in order to produce impact on clinical practice.

heart failure ; metabolic syndrome ; lipase ; lipids ; markers

European Journal of Heart Failure ; 17(Suppl1):288. Special Issue: Abstracts of the Heart Failure 2015 and the 2nd World Congress on Acute Heart Failure, Seville, Spain, 23–26th May 2015