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Research Article
Yuya Matsue
Juntendo University
Corresponding Author
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Frailty is a common comorbidity associated with adverse events in patients with heart failure, and early recognition is key to improving its management. We hypothesized that the AST to ALT ratio (AAR) could be a marker of frailty in patients with heart failure. Data from FRAGILE-HF study were analyzed. A total of 1,327 patients aged ≥ 65 years with hospitalized heart failure were divided into three groups based on their AAR at discharge: low AAR (AAR < 1.16, n = 434); middle AAR (1.16 ≤ AAR < 1.70, n = 487); high AAR (AAR ≥ 1.70, n = 406). The primary endpoint was one-year mortality. The association between AAR and physical function were also assessed. High AAR was associated with lower short physical performance battery and shorter 6-minute walk distance, and these associations were independent of age and sex. Logistic regression analysis revealed that high AAR was an independent marker of physical frailty after adjustment for age and sex. During follow-up, all-cause death occurred in 161 patients. After adjusting for confounding factors, high AAR was associated with all-cause death (low AAR vs. high AAR, hazard ratio: 1.57, 95% confidence interval, 1.02–2.42; P = 0.040). In conclusion, AAR is a marker for frailty and prognostic of all-cause mortality in older patients with heart failure.
Keywords
Frailty, comorbidity, adverse events , heart failure, AST to ALT ratio (AAR), FRAGILE-HF study
Figure 1
Figure 2
Competing interest reported. Dr. Yuya Matsue and Takatoshi Kasai are affiliated with a department endowed by Philips Respironics, ResMed, Teijin Home Healthcare, and Fukuda Denshi, and Dr. Yuya Matsue received an honorarium from Otsuka Pharmaceutical Co., Ltd., and Novartis Japan. Dr. Kagiyama reports grants from Philips, Asahi KASEI Corporation, Toho Holdings Co., Ltd, and Inter Reha Co., Ltd. outside the submitted work. Dr. Kamiya has received research funding from Eiken Chemical Co. Ltd. Other authors have nothing to declare.
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CURRENT STATUS: Under Review
Version 1
Posted 11 Mar, 2021
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Editorial decision: Major revision
On 16 Apr, 2021
Reviews received
Received 28 Mar, 2021
Reviewers agreed
On 23 Mar, 2021
Reviewers agreed
On 17 Mar, 2021
Reviewers invited
Invitations sent on 08 Mar, 2021
Editor assigned
On 07 Mar, 2021
Editor invited
On 04 Mar, 2021
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Subject Areas
Cardiac & Cardiovascular Systems
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This preprint is under consideration at Scientific Reports. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Yuya Matsue
Juntendo University
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 11 Mar, 2021
No community comments so far
Editorial decision: Major revision
On 16 Apr, 2021
Reviews received
Received 28 Mar, 2021
Reviewers agreed
On 23 Mar, 2021
Reviewers agreed
On 17 Mar, 2021
Reviewers invited
Invitations sent on 08 Mar, 2021
Editor assigned
On 07 Mar, 2021
Editor invited
On 04 Mar, 2021
Submission checks complete
On 04 Mar, 2021
First submitted
On 25 Feb, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Cardiac & Cardiovascular Systems
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Frailty is a common comorbidity associated with adverse events in patients with heart failure, and early recognition is key to improving its management. We hypothesized that the AST to ALT ratio (AAR) could be a marker of frailty in patients with heart failure. Data from FRAGILE-HF study were analyzed. A total of 1,327 patients aged ≥ 65 years with hospitalized heart failure were divided into three groups based on their AAR at discharge: low AAR (AAR < 1.16, n = 434); middle AAR (1.16 ≤ AAR < 1.70, n = 487); high AAR (AAR ≥ 1.70, n = 406). The primary endpoint was one-year mortality. The association between AAR and physical function were also assessed. High AAR was associated with lower short physical performance battery and shorter 6-minute walk distance, and these associations were independent of age and sex. Logistic regression analysis revealed that high AAR was an independent marker of physical frailty after adjustment for age and sex. During follow-up, all-cause death occurred in 161 patients. After adjusting for confounding factors, high AAR was associated with all-cause death (low AAR vs. high AAR, hazard ratio: 1.57, 95% confidence interval, 1.02–2.42; P = 0.040). In conclusion, AAR is a marker for frailty and prognostic of all-cause mortality in older patients with heart failure.
Figure 1
Figure 2
Competing interest reported. Dr. Yuya Matsue and Takatoshi Kasai are affiliated with a department endowed by Philips Respironics, ResMed, Teijin Home Healthcare, and Fukuda Denshi, and Dr. Yuya Matsue received an honorarium from Otsuka Pharmaceutical Co., Ltd., and Novartis Japan. Dr. Kagiyama reports grants from Philips, Asahi KASEI Corporation, Toho Holdings Co., Ltd, and Inter Reha Co., Ltd. outside the submitted work. Dr. Kamiya has received research funding from Eiken Chemical Co. Ltd. Other authors have nothing to declare.
This is a list of supplementary files associated with this preprint. Click to download.
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