Why the study?
While alpha-ketoglutarate reflects adverse short-term outcomes in heart failure patients, its long-term prognostic value in acute heart failure was unclear.
Does elevated plasma alpha-ketoglutarate (AKG) predict long-term all-cause mortality in patients hospitalized with acute heart failure?
Does elevated plasma alpha-ketoglutarate (AKG) predict long-term all-cause mortality in patients hospitalized with acute heart failure?
Plasma alpha-ketoglutarate is an independent predictor of long-term all-cause mortality in acute heart failure, providing prognostic value even in patients with relatively low NT-proBNP levels.
Answers are grounded in this paper and cite their sources.
Elevated AKG may refine long-term mortality risk stratification in AHF beyond NT-proBNP; leaves open whether routine measurement improves outcomes.
Background and Objective Alpha-ketoglutarate (AKG), is a major intermediate metabolite of the tricarboxylic acid cycle, and is closely associated with cardiometabolic disease prognosis. Previous studies indicated that AKG is related to myocardial energy expenditure levels and reflects adverse short-term outcomes in heart failure (HF) patients. In this prospective cohort study, we examined the long-term prognostic value of AKG levels in acute HF (AHF) patients.Methods Plasma AKG levels were assessed in patients hospitalized with AHF. Hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause mortality were calculated via multiple Cox regression. All-cause mortality was compared between patients with NT-proBNP < 1000 pg/ml and those with NT-proBNP ≥ 1000 pg/ml via subgroup analysis.Results Patients with AKG ≥ 9.83 μg/ml had higher heart rates and NT-proBNP and lower left ventricular ejection fraction (LVEF) and systolic blood pressure (SBP). After multiple adjustment, higher AKG was associated with an increased all-cause mortality risk (HR = 1.078, p < 0.001). Compared with AKG < 9.83 μg/ml, AKG ≥ 9.83 μg/ml nearly doubled (HR = 1.929, p < 0.001) and quadrupled (HR = 4.160, p < 0.001) the all-cause mortality risk in patients with NT-proBNP ≥ 1000 pg/ml and those with NT-proBNP < 1000 pg/ml, respectively.Conclusions and Relevance Plasma AKG was independently associated with greater all-cause mortality risk in patients with AHF. Higher AKG levels retained prognostic value for patients with relatively low NT-proBNP.
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Xu et al. (2025) studied this question.
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