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High-sensitivity c-reactive protein is associated with heart failure hospitalization in patients with metabolic dysfunction-associated fatty liver disease and normal left ventricular ejection fraction undergoing coronary angiography

High-sensitivity c-reactive protein is associated with heart failure hospitalization in patients with metabolic dysfunction-associated fatty liver disease and normal left ventricular ejection fraction undergoing coronary angiography
High-sensitivity c-reactive protein is associated with heart failure hospitalization in patients with metabolic dysfunction-associated fatty liver disease and normal left ventricular ejection fraction undergoing coronary angiography

BACKGROUND: Systemic chronic inflammation plays a role in the pathophysiology of both heart failure with preserved ejection fraction (HFpEF) and metabolic dysfunction-associated fatty liver disease. This study aimed to investigate whether serum hs-CRP (high-sensitivity C-reactive protein) levels were associated with the future risk of heart failure (HF) hospitalization in patients with metabolic dysfunction-associated fatty liver disease and a normal left ventricular ejection fraction. METHODS AND RESULTS: The study enrolled consecutive individuals with metabolic dysfunction-associated fatty liver disease and normal left ventricular ejection fraction who underwent coronary angiography for suspected coronary heart disease. The study population was subdivided into non-HF, pre-HFpEF, and HFpEF groups at baseline. The study outcome was time to the first hospitalization for HF. In 10 019 middle-aged individuals (mean age, 63.3±10.6 years; 38.5% women), the prevalence rates of HFpEF and pre-HFpEF were 34.2% and 34.5%, with a median serum hs-CRP level of 4.5 mg/L (interquartile range, 1.9–10 mg/L) and 5.0 mg/L (interquartile range, 2.1–10.1 mg/L), respectively. Serum hs-CRP levels were significantly higher in the pre-HFpEF and HFpEF groups than in the non-HF group. HF hospitalizations occurred in 1942 (19.4%) patients over a median of 3.2 years, with rates of 3.7% in non-HF, 20.8% in pre-HFpEF, and 32.1% in HFpEF, respectively. Cox regression analyses showed that patients in the highest hs-CRP quartile had a ≈4.5-fold increased risk of being hospitalized for HF compared with those in the lowest hs-CRP quartile (adjusted-hazard ratio, 4.42 [95% CI, 3.72–5.25]). CONCLUSIONS: There was a high prevalence of baseline pre-HFpEF and HFpEF in patients with metabolic dysfunction-associated fatty liver disease and suspected coronary heart disease. There was an increased risk of HF hospitalization in those with elevated hs-CRP levels.

heart failure hospitalization, heart failure with preserved ejection fraction, high‐sensitivity C‐reactive protein, metabolic dysfunction‐associated fatty liver disease, metabolic dysfunction‐associated steatotic liver disease, metabolic dysfunction-associated fatty liver disease, high-sensitivity C-reactive protein, metabolic dysfunction-associated steatotic liver disease
e032997
Zhou, Xiao-Dong
f453ed30-d7eb-43ee-b17d-9d74ca555044
Chen, Qin-Fen
131da31c-75ec-48c1-9d86-36ae6cf74d57
Targher, Giovanni
cebd574c-a8cc-4b7a-a858-b7403443005a
Byrne, Christopher D.
1370b997-cead-4229-83a7-53301ed2a43c
Shapiro, Michael D.
dd997bd6-e949-48c0-93b8-d0acc77bbebf
Tian, Na
7dbbc2ca-e686-4dcb-b05e-741940fea436
Xiao, Tie
36ea273d-0d20-4adb-92b1-fd53f6565d8b
Sung, Ki-Chul
7d2fab68-3cb1-44a6-9c6e-0dea66723669
Lip, Gregory Y.H.
1e23eece-df44-4d09-b111-efde64084cb0
Zheng, Ming-Hua
89a1a1ec-7b30-4405-93fa-d0cc58e9274e
Zhou, Xiao-Dong
f453ed30-d7eb-43ee-b17d-9d74ca555044
Chen, Qin-Fen
131da31c-75ec-48c1-9d86-36ae6cf74d57
Targher, Giovanni
cebd574c-a8cc-4b7a-a858-b7403443005a
Byrne, Christopher D.
1370b997-cead-4229-83a7-53301ed2a43c
Shapiro, Michael D.
dd997bd6-e949-48c0-93b8-d0acc77bbebf
Tian, Na
7dbbc2ca-e686-4dcb-b05e-741940fea436
Xiao, Tie
36ea273d-0d20-4adb-92b1-fd53f6565d8b
Sung, Ki-Chul
7d2fab68-3cb1-44a6-9c6e-0dea66723669
Lip, Gregory Y.H.
1e23eece-df44-4d09-b111-efde64084cb0
Zheng, Ming-Hua
89a1a1ec-7b30-4405-93fa-d0cc58e9274e

Zhou, Xiao-Dong, Chen, Qin-Fen, Targher, Giovanni, Byrne, Christopher D., Shapiro, Michael D., Tian, Na, Xiao, Tie, Sung, Ki-Chul, Lip, Gregory Y.H. and Zheng, Ming-Hua (2024) High-sensitivity c-reactive protein is associated with heart failure hospitalization in patients with metabolic dysfunction-associated fatty liver disease and normal left ventricular ejection fraction undergoing coronary angiography. Journal of the American Heart Association, 13 (3), e032997, [e032997]. (doi:10.1161/JAHA.123.032997).

Record type: Article

Abstract

BACKGROUND: Systemic chronic inflammation plays a role in the pathophysiology of both heart failure with preserved ejection fraction (HFpEF) and metabolic dysfunction-associated fatty liver disease. This study aimed to investigate whether serum hs-CRP (high-sensitivity C-reactive protein) levels were associated with the future risk of heart failure (HF) hospitalization in patients with metabolic dysfunction-associated fatty liver disease and a normal left ventricular ejection fraction. METHODS AND RESULTS: The study enrolled consecutive individuals with metabolic dysfunction-associated fatty liver disease and normal left ventricular ejection fraction who underwent coronary angiography for suspected coronary heart disease. The study population was subdivided into non-HF, pre-HFpEF, and HFpEF groups at baseline. The study outcome was time to the first hospitalization for HF. In 10 019 middle-aged individuals (mean age, 63.3±10.6 years; 38.5% women), the prevalence rates of HFpEF and pre-HFpEF were 34.2% and 34.5%, with a median serum hs-CRP level of 4.5 mg/L (interquartile range, 1.9–10 mg/L) and 5.0 mg/L (interquartile range, 2.1–10.1 mg/L), respectively. Serum hs-CRP levels were significantly higher in the pre-HFpEF and HFpEF groups than in the non-HF group. HF hospitalizations occurred in 1942 (19.4%) patients over a median of 3.2 years, with rates of 3.7% in non-HF, 20.8% in pre-HFpEF, and 32.1% in HFpEF, respectively. Cox regression analyses showed that patients in the highest hs-CRP quartile had a ≈4.5-fold increased risk of being hospitalized for HF compared with those in the lowest hs-CRP quartile (adjusted-hazard ratio, 4.42 [95% CI, 3.72–5.25]). CONCLUSIONS: There was a high prevalence of baseline pre-HFpEF and HFpEF in patients with metabolic dysfunction-associated fatty liver disease and suspected coronary heart disease. There was an increased risk of HF hospitalization in those with elevated hs-CRP levels.

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Accepted/In Press date: 18 December 2023
e-pub ahead of print date: 19 January 2024
Published date: 6 February 2024
Additional Information: Publisher Copyright: © 2024 The Authors.
Keywords: heart failure hospitalization, heart failure with preserved ejection fraction, high‐sensitivity C‐reactive protein, metabolic dysfunction‐associated fatty liver disease, metabolic dysfunction‐associated steatotic liver disease, metabolic dysfunction-associated fatty liver disease, high-sensitivity C-reactive protein, metabolic dysfunction-associated steatotic liver disease

Identifiers

Local EPrints ID: 485795
URI: http://eprints.soton.ac.uk/id/eprint/485795
PURE UUID: f02751e0-dec7-4948-bd1e-05e5890c2f1f
ORCID for Christopher D. Byrne: ORCID iD orcid.org/0000-0001-6322-7753

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Date deposited: 19 Dec 2023 17:43
Last modified: 14 May 2024 01:35

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Contributors

Author: Xiao-Dong Zhou
Author: Qin-Fen Chen
Author: Giovanni Targher
Author: Michael D. Shapiro
Author: Na Tian
Author: Tie Xiao
Author: Ki-Chul Sung
Author: Gregory Y.H. Lip
Author: Ming-Hua Zheng

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