A retrospective study on the relationship between plasma β-hydroxybutyric acid levels and short-term prognosis of cardiac function in patients with acute myocardial infarction combined with heart failure

Abstract

Background: Ketone body metabolism can improve cardiomyocytes metabolism and reduce myocardial oxygen consumption; however, its role in the short-term prognosis of patients with acute myocardial infarction combined with heart failure has not been clearly elucidated. The aim of this study was to investigate the effect of β-hydroxybutyric acid, the main component of ketone bodies, on the short-term prognosis of patients with acute myocardial infarction combined with heart failure.

Methods: This was a retrospective observational study that enrolled patients admitted to the Qilu Hospital of Shandong University for acute myocardial infarction combined with heart failure between January 1, 2019, and December 31, 2022. According to whether β-hydroxybutyric acid was elevated or not, subjects were divided into a β-hydroxybutyric acid elevated and nonelevated groups, to observe the difference in cardiac function improvement between the two groups.

Results: This study included a total of 260 patients, of which 170 exhibited elevated levels of β-hydroxybutyric acid. Compared to the patients in the nonelevated group, patients in the elevated β-hydroxybutyric acid group had higher plasma levels of creatine kinase myocardial band and greater Gensini scores. Multivariate logistic regression analysis indicated that an increase in β-hydroxybutyric acid levels (odds ratio: 3.076; 95% confidence intervals: 1.479-6.395; P = 0.003) is an independent protective factor affecting the prognosis of cardiac function in patients with acute myocardial infarction combined with heart failure.

Conclusion: In patients with acute myocardial infarction combined with heart failure, plasma β-hydroxybutyric acid serves as an independent protective factor for short-term improvement in cardiac function.

Keywords

Acute myocardial infarction / Energy metabolism / Heart failure / β-Hydroxybutyric acid

Conflict of interest statement

Yuguo Chen, Editor-in-Chief of Emergency and Critical Care Medicine, confirms no involvement in any stage of this article’s peer-review process, ensuring unbiased editorial decision-making. The authors declare no conflict of interest.

Author contributions

All authors participated in the conception and design of the study, provision of study materials and patients, collection and assembly of data, data analysis and interpretation, and writing of the manuscript.

Funding

This study was supported by the State Key Program of the National Natural Science Foundation of China (82030059), National Natural Science Foundation of China (82172178, 82072144, 81873950, 81873953, 81300219, 81671951), National Key R&D Program of China (2020YFC1512700, 2020YFC1512705, 2020YFC1512703), National S&T Fundamental Resources Investigation Project (2018FY100600, 2018FY100602), Natural Science Foundation of Shandong Province (ZR2022MH078), Key R&D Program of Shandong Province (2019GSF108131), Taishan Pandeng Scholar Program of Shandong Province (tspd20181220), Taishan Young Scholar Program of Shandong Province (tsqn202103173, tsqn20161065, tsqn201812129), Youth Top-Talent Project of National Ten Thousand Talents Plan, and Qilu Young Scholar Program.

Ethical approval of studies and informed consent

The study followed the principles of the Declaration of Helsinki as revised in 2013. The study protocol was approved by the ethics com-mittee of the Qilu Hospital of Shandong University (KYLL-202011-204; December 28, 2020). The data has been anonymized to protect patient privacy. Written informed consent was waived by the ethics committee of Qilu Hospital of Shandong University, owing to the anonymized retrospective nature of the analysis.

Acknowledgments

None.

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