Serum biomarkers and clinical outcomes in heart failure patients treated de novo with carvedilol

Background: The role of infl ammatory and hemodynamic stress biomarkers in heart failure(HF) patients treated de novo with beta-blockers has been poorly studied.Methods: A total of 86 patients (age 56 ± 9 years, 81 men) with left ventricular ejection fraction(LVEF) < 40% and previously not treated with beta-blockers were initiated on carvedilol.At baseline and 12 months later we performed echocardiography, cardiopulmonary exercisetesting, and determined serum levels of B-type natriuretic peptide (BNP), endothelin-1 (ET-1),C-reactive protein (CRP), interleukin-6, and tumor necrosis factor alpha (TNF -a). Patientswere followed up over a total period of 9 ± 3 years from baseline.Results: Increased baseline CRP and its on-treatment decrease were associated with improvementof LVEF (est. coeffi cient per one SD: 1.6; 95% CI: –0.05,3.28; p = 0.056, and –1.80;–3.43, –0.18; p = 0.030, respectively) and diminishing of LV end-systolic volume index[mL/m2] (–6.83; –11.32; –2.34; p = 0.003, and 5.85; 1.23; –10.46; p = 0.014, respectively).Higher baseline ET-1 and on-treatment increase in TNF-a predicted frequent admissions(> 1) for cardiac complications (odds ratio per one SD: 1.98; 95% CI: 1.09–3.59;p = 0.025, and 2.07, 1.12–3.84, p = 0.021, respectively) whereas higher baseline BNP wasasociated with increased mortality (hazard ratio per one SD: 2.09, 95% CI: 1.26–3.45;p = 0.004).Conclusions: Serum biomarkers may have different roles in prediction of clinical outcomesamong HF patients treated de novo with carvedilol

Relationship between polyunsaturated fatty acid composition in serum phospholipids, systemic low-grade inflammation, and glycemic control in patients with type 2 diabetes and atherosclerotic cardiovascular disease

Abstract Background There are inconsistent data about the role of serum phospholipid fatty acid composition in patients with type 2 diabetes (T2DM) and atherosclerotic cardiovascular disease (ASCVD). The aim of the study was to investigate the relationship between serum phospholipid fatty acid composition, systemic low-grade inflammation, and glycemic control in high-risk T2DM patients. Methods Seventy-four patients (26% women, mean age 65.6 ± 6.8 years) with T2DM (median diabetes duration 10 years) and documented ASCVD (74 with coronary artery disease, 26 with peripheral arterial disease) were enrolled in the study. Baseline HbA1c was estimated using turbidimetric inhibition immunoassay. According to the median value of HbA1c the patients were grouped into those with HbA1c < 7.0% (< 53 mmol/mol) (n = 38) and those with HbA1c ≥ 7.0% (≥ 53 mmol/mol) (n = 36). Serum phospholipid fatty acids were measured with gas chromatography. Results Patients with HbA1c ≥ 7.0%, compared with those with HbA1c < 7.0% had similar composition of saturated and monounsaturated fatty acids in serum phospholipids, but had higher concentrations of linoleic acid (LA) and higher n-6/n-3 polyunsaturated fatty acid (PUFA) ratio as well as lower levels of eicosapentaenoic acid (EPA), total n-3 PUFAs, and the EPA/arachidonic acid ratio. We found that LA (r = 0.25; p = 0.03) and n-6/n-3 PUFA ratio (r = 0.28; p = 0.02) were positively correlated with HbA1c. Multivariate logistic regression analysis showed that n-6/n-3 PUFA ratio, hsCRP and T2DM duration were independent predictors of worse glycemic control in patients with T2DM and ASCVD. Conclusions This study showed that glycemic control in high-risk T2DM patients with ASCVD was significantly associated with unfavorable serum phospholipid n-6/n-3 PUFA ratio and greater systemic inflammation

MOESM1 of Treatment with high-dose n-3 PUFAs has no effect on platelet function, coagulation, metabolic status or inflammation in patients with atherosclerosis and type 2 diabetes

Additional file 1: Table S1. Concentration of serum fatty acids of the phospholipid fraction before and after 3 months of either placebo or n-3 PUFA treatment