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Research Article

Amino Acid-Based Metabolic Panel Provides Robust Prognostic Value Additive to B-Natriuretic Peptide and Traditional Risk Factors in Heart Failure

Table 1

Demographic and laboratory data in normal controls and heart failure patients at different ACC/AHA stages (Initiation cohort).

NormalStage AStage BStage CStage D
for trend

Age (years)53.7 ± 8.058.6 ± 11.460.9 ± 12.360.7 ± 14.261.5 ± 13.0<0.001
Male (%)46 (35.7)64 (68.8)83 (69.2)263 (66.1)66 (65.3)0.465
LVEF (%)71.1 ± 11.964.8 ± 15.946.2 ± 15.433.1 ± 11.328.7 ± 10.4<0.001
Blood pressure (mm Hg)
 Systolic123.2 ± 15.5127.4 ± 17.7124.9 ± 20.8123.4 ± 18.5117.2 ± 17.4<0.001
 Diastolic74.3 ± 11.477.6 ± 11.076.1 ± 14.174.5 ± 12.573.1 ± 13.10.008
Heart rate, beats/min73.1 ± 11.575.6 ± 13.574.6 ± 14.177.3 ± 11.879.4 ± 13.10.016
Comorbidity
 Diabetes mellitus (%)0 (0)30 (32.3)45 (37.5)156 (39.2)46 (45.5)0.046
 Chronic kidney disease (%)0 (0)16 (17.2)20 (16.7)97 (24.4)29 (28.7)0.015
 Hypertension (%)0 (0)51 (54.8)87 (72.5)255 (61.1)68 (67.3)0.287
 Atrial fibrillation (%)0 (0)3 (3.2)31 (25.8)135 (33.9)34 (33.7)<0.001
 COPD (%)0 (0)6 (6.5)12 (10.0)45 (11.3)11 (10.9)0.239
Ischemia (%)0 (0)45 (48.4)80 (66.7)175 (44.0)48 (47.5)0.059
Body mass index (kg/m2)24.1 ± 3.925.1 ± 4.025.8 ± 4.425.2 ± 5.325.9 ± 7.90.368
Medication
 ACEI or ARB (%)0 (0)28 (30.1)94 (78.3)358 (89.9)92 (91.1)<0.001
β-Blocker (%)0 (0)31 (33.3)90 (75.0)301 (75.6)67 (66.3)<0.001
 Diuretic (%)0 (0)11 (11.81)45 (37.5)236 (59.3)71 (70.3)<0.001
Laboratory data
 BNP (log)0.94 ± 0.291.39 ± 0.722.13 ± 0.652.58 ± 0.542.92 ± 0.41<0.001
 Cholesterol (mg/dL)211.1 ± 34.8192.7 ± 53.2189.4 ± 53.0177.2 ± 45.8157.3 ± 36.0<0.001
 Triglyceride (mg/dL)102.2 ± 58.2153.7 ± 102.4142.1 ± 96.8126.8 ± 80.2114.5 ± 93.10.001
 Serum sodium (mEq/L)140.2 ± 1.1138.6 ± 4.2139.2 ± 2.4139.1 ± 3.3138.3 ± 3.30.468
 Hemoglobin (g/dL)13.87 ± 1.4013.98 ± 1.6813.55 ± 1.9713.35 ± 2.1212.95 ± 2.06<0.001
 Albumin (g/dL)4.29 ± 0.724.05 ± 0.593.80 ± 0.493.61 ± 0.473.32 ± 0.51<0.001
 ALT (U/L)26.6 ± 14.029.0 ± 20.224.2 ± 12.924.9 ± 15.728.6 ± 22.10.951
γGT (U/L)26.5 ± 19.642.4 ± 56.747.5 ± 48.268.5 ± 137.1143.3 ± 117.10.001
 eGFR (mL/min/1.73 m2)99.8 ± 18.475.7 ± 24.079.1 ± 29.572.1 ± 28.461.9 ± 21.5<0.001
 QRS complex, msec90.3 ± 10.493.7 ± 18.196.9 ± 19.1103.3 ± 25.9110.7 ± 25.6<0.001
 HOP score−4.50 ± 4.881.82 ± 4.424.10 ± 5.1110.77 ± 4.1318.00 ± 5.02<0.001
  Histidine (μM)95.2 ± 17.288.8 ± 14.383.2 ± 16.974.1 ± 14.771.6 ± 20.5<0.001
  Ornithine (μM)59.7 ± 19.568.7 ± 27.977.1 ± 30.5101.4 ± 36.5114.8 ± 49.5<0.001
  Phenylalanine (μM)57.0 ± 8.562.3 ± 10.566.6 ± 16.775.6 ± 18.889.0 ± 30.6<0.001

Comparison among patients from stages A to D. ACC/AHA: American College of Cardiology/American Heart Association; ACEI: angiotensin-converting enzyme inhibitor; ALT: alanine aminotransferase; ARB: angiotensin receptor blocker; COPD: chronic obstructive pulmonary disease; chronic kidney disease, estimated glomerular filtration rate ; HF: heart failure; HOP: histidine, ornithine, and phenylalanine; LVEF: left ventricular ejection fraction; γGT: γ-glutamyltransferase.

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