The addition of alpha-ketoglutarate to NT-proBNP improves the prediction of long-term all-cause mortality in acute heart failure patients
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-...
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Taylor & Francis Group
2025-12-01
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| Series: | Annals of Medicine |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2025.2477827 |
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| author | Tianyu Xu Hao Zhang Zhengliang Peng Yuli Huang Qiong Zhan Zhuang Ma Xianghui Zeng Chen Liu Qingchun Zeng Yugang Dong Dingli Xu |
| author_facet | Tianyu Xu Hao Zhang Zhengliang Peng Yuli Huang Qiong Zhan Zhuang Ma Xianghui Zeng Chen Liu Qingchun Zeng Yugang Dong Dingli Xu |
| author_sort | Tianyu Xu |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-125908f0df4c47c8be5f19e6cdc500f7 |
| institution | DOAJ |
| issn | 0785-3890 1365-2060 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Annals of Medicine |
| spelling | doaj-art-125908f0df4c47c8be5f19e6cdc500f72025-08-20T02:55:48ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602025-12-0157110.1080/07853890.2025.2477827The addition of alpha-ketoglutarate to NT-proBNP improves the prediction of long-term all-cause mortality in acute heart failure patientsTianyu Xu0Hao Zhang1Zhengliang Peng2Yuli Huang3Qiong Zhan4Zhuang Ma5Xianghui Zeng6Chen Liu7Qingchun Zeng8Yugang Dong9Dingli Xu10NHC Key Laboratory of Assisted Circulation and Vascular Diseases, Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, ChinaState Key Laboratory of Organ Failure Research, Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaDepartment of Emergency, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, ChinaDepartment of Cardiology, Shunde Hospital, Southern Medical University (the First People’s Hospital of Shunde), Foshan, ChinaState Key Laboratory of Organ Failure Research, Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaState Key Laboratory of Organ Failure Research, Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaState Key Laboratory of Organ Failure Research, Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaNHC Key Laboratory of Assisted Circulation and Vascular Diseases, Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, ChinaState Key Laboratory of Organ Failure Research, Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaNHC Key Laboratory of Assisted Circulation and Vascular Diseases, Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, ChinaState Key Laboratory of Organ Failure Research, Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaBackground 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.https://www.tandfonline.com/doi/10.1080/07853890.2025.2477827Alpha-ketoglutarateNT-proBNPprognosislong-term all-cause mortalityheart failure |
| spellingShingle | Tianyu Xu Hao Zhang Zhengliang Peng Yuli Huang Qiong Zhan Zhuang Ma Xianghui Zeng Chen Liu Qingchun Zeng Yugang Dong Dingli Xu The addition of alpha-ketoglutarate to NT-proBNP improves the prediction of long-term all-cause mortality in acute heart failure patients Annals of Medicine Alpha-ketoglutarate NT-proBNP prognosis long-term all-cause mortality heart failure |
| title | The addition of alpha-ketoglutarate to NT-proBNP improves the prediction of long-term all-cause mortality in acute heart failure patients |
| title_full | The addition of alpha-ketoglutarate to NT-proBNP improves the prediction of long-term all-cause mortality in acute heart failure patients |
| title_fullStr | The addition of alpha-ketoglutarate to NT-proBNP improves the prediction of long-term all-cause mortality in acute heart failure patients |
| title_full_unstemmed | The addition of alpha-ketoglutarate to NT-proBNP improves the prediction of long-term all-cause mortality in acute heart failure patients |
| title_short | The addition of alpha-ketoglutarate to NT-proBNP improves the prediction of long-term all-cause mortality in acute heart failure patients |
| title_sort | addition of alpha ketoglutarate to nt probnp improves the prediction of long term all cause mortality in acute heart failure patients |
| topic | Alpha-ketoglutarate NT-proBNP prognosis long-term all-cause mortality heart failure |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2025.2477827 |
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