The Prognostic Implication of Metabolic Syndrome in Patients with Heart Failure

Yoon, Hyun Ju; Ahn, Youngkeun; Kim, Kye Hun; Park, Jong Chun; Choi, Dong‐Ju; Han, Seongwoo; Jeon, Eun‐Seok; Cho, Myung-Chan; Kim, Jae‐Joong; Yoo, Byung‐Su; Shin, Mi-Seung; Seong, In‐Whan; Kang, Seok-Min; Kim, Yung-Jo; Kim, Hyung Seop; Chae, Shung Chull; Oh, Byung‐Hee; Lee, Myung-Mook; Ryu, Kyu-Hyung

doi:10.4070/kcj.2013.43.2.87

Cited by 7 publications

(5 citation statements)

References 27 publications

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“…However, there are still great controversies about the impact of MS on the prognosis in patients with established HF. Some studies had reported that HF patients with MS had a significantly reduced risk of in-hospital mortality ( 9 ), as well as long-term all-cause mortality ( 10 , 11 ), compared with HF patients without MS. However, such association was not documented in other studies ( 12 , 13 ), raising concern of whether such “epidemiologic paradox” was true in the HF–MS relationship.…”

Section: Introductionmentioning

confidence: 99%

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

Huang

Chen

et al. 2021

Front. Cardiovasc. Med.

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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.

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Section: Introductionmentioning

confidence: 99%

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

Huang

Chen

et al. 2021

Front. Cardiovasc. Med.

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“…There was no relation suggested by Mets to uncontrolled BP group. It can be explained by the risk profile of subjects requiring three or more drugs and coronary artery disease patients too different to be compared with the most populations where Mets implied cardiovascular risk [ 16 ]. Smoking was usually known to be associated with elevation of daytime BP or masked HT.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of resistant hypertension and associated factors for blood pressure control status using Korean ambulatory blood pressure monitoring registry data

et al. 2016

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BackgroundResistant hypertension (RH) may be one of the cause of the plateau in improving the control rate in hypertension (HT) management. The misdiagnosis of RH by clinic blood pressure (BP) is important clinical problem. Aim of the study were to investigate the prevalence of RH by ambulatory blood pressure monitoring (ABPM) and the factor associated with control status of ambulatory BPs.MethodsFor 1230 subjects taking one or more antihypertensive medication (AHM) enrolled in the Korean Ambulatory Blood Pressure Monitoring (Kor-ABP) registry, the prevalence of RH was calculated which was defined as uncontrolled BP by three AHM classes including diuretic or BP in need of four or more AHM classes. The prevalence determined by clinic versus ambulatory BP was compared.ResultsThe age was 59.3 ± 12.5 years, and 44.3 % were female (n = 1230). Among them 72 subjects were taking three AHM drugs including diuretics and 105 subjects were taking four or more AHM classes. With uncontrolled daytime ambulatory BP in 41 among 72 subjects, prevalence of RH was 11.9 % (146/1230). By using nighttime BP criteria, there was significant difference in the prevalence of RH for clinic versus nighttime BP (146/177 vs. 159/177, p = 0.0124). For control status of daytime BP, masked uncontrolled BP was 16.9 % and controlled BP with white-coat effect was 14.1 %. For nighttime BP control status, odd ratios for smoking (0.624), drinking (1.512), coronary artery disease (0.604), calcium antagonist (1.705), and loop diuretics (0.454) were all significant.ConclusionThe prevalence itself was 11.9 % by daytime BP and it was significantly higher when using nighttime BP criteria. Control status of daytime BP was misclassified in 31.0 %. Smoking, drinking, coronary artery disease, calcium antagonist, and loop diuretics were associated with nighttime BP control status.

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“…Fourth, the effect of the TyG index on the prognosis of HF patients was more prominent in the MetS group, which was confirmed by our study. What is more, extracardiac comorbidities (including obesity, hypertension, diabetes, and MetS) affect a high proportion of HFpEF patients [ 42 , 43 ]. Finally, although it is suggested that HFmrEF may be a transitional state between HFpEF and HFrEF [ 44 ], patients with HFmrEF have clinical features and prognoses that are more similar to those of patients with HFpEF than those of patients with HFrEF [ 45 ].…”

Section: Discussionmentioning

confidence: 99%

Association between the triglyceride–glucose index and the risk of mortality among patients with chronic heart failure: results from a retrospective cohort study in China

Zhou

Wang

Che³

et al. 2023

Cardiovasc Diabetol

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Background The triglyceride–glucose (TyG) index has been demonstrated to be a reliable surrogate marker of insulin resistance (IR) and an effective predictive index of cardiovascular (CV) disease risk. However, its long-term prognostic value in patients with chronic heart failure (CHF) remains uncertain. Methods A total of 6697 consecutive patients with CHF were enrolled in this study. Patients were divided into tertiles according to their TyG index. The incidence of primary outcomes, including all-cause death and CV death, was recorded. The TyG index was calculated as ln [fasting triglycerides (mg/dL) × fasting blood glucose (mg/dL)/2]. Results During a median follow-up of 3.9 years, a total of 2158 (32.2%) all-cause deaths and 1305 (19.5%) CV deaths were documented. The incidence of primary events from the lowest to the highest TyG index tertiles were 50.61, 64.64, and 92.25 per 1000 person-years for all-cause death and 29.05, 39.40, and 57.21 per 1000 person-years for CV death. The multivariate Cox hazards regression analysis revealed hazard ratios for all-cause and CV deaths of 1.84 (95% CI 1.61–2.10; P for trend < 0.001) and 1.94 (95% CI 1.63–2.30; P for trend < 0.001) when the highest and lowest TyG index tertiles were compared. In addition, the predictive ability of the TyG index against all-cause death was more prominent among patients with metabolic syndrome and those with heart failure with preserved ejection fraction phenotype (both P for interaction < 0.05). Furthermore, adding the TyG index to the established model for all-cause death improved the C‑statistic value (0.710 for the established model vs. 0.723 for the established model + TyG index, P < 0.01), the integrated discrimination improvement value (0.011, P < 0.01), the net reclassification improvement value (0.273, P < 0.01), and the clinical net benefit (probability range, 0.07–0.36). Conclusions The TyG index was significantly associated with the risk of mortality, suggesting that it may be a reliable and valuable predictor for risk stratification and an effective prognostic indicator in patients with CHF.

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The Prognostic Implication of Metabolic Syndrome in Patients with Heart Failure

Cited by 7 publications

References 27 publications

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

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

Prevalence of resistant hypertension and associated factors for blood pressure control status using Korean ambulatory blood pressure monitoring registry data

Association between the triglyceride–glucose index and the risk of mortality among patients with chronic heart failure: results from a retrospective cohort study in China

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