Serumska endotelna lipaza, lipidni i upalni pokazatelji u bolesnika s akutnim zatajivanjem srca i metaboličkim sindromom [Serum endothelial lipase, lipids and inflammatory markers in acute heart failure patients with metabolic syndrome]

The study aimed to investigate whether patients with acute heart failure and concomitant metabolic syndrome have worse outcome, longer hospitalisation, higher in-hospital and three-month follow-up mortality; severity of clinical presentation, levels of endothelial lipase, lipids and inflammatory markers; whether female patients have worse clinical presentation and more comorbidities. The study was performed as a prospective, single-centre, observational research on 152 patients, defined and categorised according to the ESC and ACCF/AHA Guidelines for HF. Mean age was 75.2 years (SD 10.3), 52% female, mean BMI 28.8 kg/m2 (SD 5.4). Hospital mortality was 14.5%, three-month 27.4%, length of hospitalisation 11.34 (SD 9.26) days. Patients with metabolic syndrome and women had higher endothelial lipase. Higher total cholesterol and LDL were associated with lower in-hospital and three-month follow-up mortality. Lower HDL and higher IL-6 were associated with higher three-month mortality. Results of this study suggest that „Obesity paradox“ and „Reverse epidemiology“ emerged. Patients with metabolic syndrome were longer hospitalised, however patients without metabolic syndrome had higher odds ratio of in-hospital and three-month mortality. Female gender was not associated with higher mortality. To conclude, results emphasise importance of diagnosing metabolic syndrome, hypolipemic therapy re-evaluation and continuous development of diagnostic biomarkers.