Prognostic Impact of Metabolic Syndrome in Patients With Heart Failure: A Meta-Analysis of Observational Studies

Abstract

Background: The metabolic syndrome (MS) is significantly associated with the risk of incident heart failure (HF). However, there are still great controversies about the impact of MS on the prognosis in patients with established HF. This meta-analysis aimed to ascertain the effect of MS on the prognosis in patients with HF.Methods: We searched multiple electronic databases, including PubMed, Opengrey, EMBASE, and Cochran Library, for potential studies up to February 15, 2021. Observational studies that reported the impact of MS on the prognosis in patients with established HF were included for meta-analysis.Results: Ten studies comprising 18,590 patients with HF were included for meta-analysis. The median follow-up duration of the included studies was 2.4 years. Compared with HF patients without MS, the risk of all-cause mortality and cardiovascular mortality was not increased in HF with MS (HR = 1.04, 95% CI = 0.88–1.23 for all-cause mortality; HR = 1.66, 95% CI = 0.56–4.88 for cardiovascular mortality, respectively). However, there was a significant increase in composited cardiovascular events in the HF patients with MS compared with those without MS (HR = 1.73, 95% CI = 1.23–2.45).Conclusions: In patients with established HF, the presence of MS did not show an association on the risk of all-cause mortality or cardiovascular mortality, while it may increase the risk of composite cardiovascular events.

Biomarker signature and pathophysiological pathways in patients with chronic heart failure and metabolic syndrome

“…Although the prevalence of metabolic syndrome in CVD is highly dependent on the definition, demographics, ethnicity, and gender, it is widely known that this patient group has a considerably higher risk of CVD and heart failure. 3,17 Our study confirms the high prevalence of metabolic syndrome in the population of patients with chronic heart failure. These patients also appeared .…”

“…2 The presence of metabolic syndrome is associated with a two-fold higher risk of developing heart failure. 3 Additionally, adverse progression of metabolic syndrome significantly influences the therapeutic management of heart failure. 1 The increased risk of heart failure seems intuitive because of the combination of factors that define metabolic syndrome.…”

“…Metabolic syndrome and heart failure are both highly prevalent and gradually increasing conditions in the general population 2 . The presence of metabolic syndrome is associated with a two‐fold higher risk of developing heart failure 3 . Additionally, adverse progression of metabolic syndrome significantly influences the therapeutic management of heart failure 1 .…”

Association between prediabetes and adverse outcomes in heart failure

“…Although we cannot totally exclude the possibility that the association between prediabetes and poor prognosis in patients with HF was mediated by the presence of metabolic syndrome, the sensitivity analysis showed that prediabetes was still associated with an increased risk of all‐cause mortality in patients with HF independent of BMI (the most important metric for defining metabolic syndrome). Furthermore, a recently published meta‐analysis reported that metabolic syndrome is not associated with the risk of all‐cause mortality or cardiovascular mortality in patients with HF 49 . Therefore, we think the association between prediabetes and poor prognosis in HF is not mediated by the presence of metabolic syndrome.…”

“…Furthermore, a recently published meta-analysis reported that metabolic syndrome is not associated with the risk of all-cause mortality or cardiovascular mortality in patients with HF. 49 Therefore, we think the association between prediabetes and poor prognosis in HF is not mediated by the presence of metabolic syndrome.…”