# Ketonlichamen en functionele uitkomsten na STEMI

*geplaatst 2021-10-05 · Hartfalen · Journal of the American College of Cardiology · doi 10.1016/j.jacc.2021.07.054 · https://hartvaat.nl/2021/10/05/ketonlichamen-en-functionele-uitkomsten-na-stemi/*

Studie naar de associatie van circulerende ketonlichamen met functionele uitkomsten na STEMI.

## English: Association of Circulating Ketone Bodies With Functional Outcomes After ST-Segment Elevation Myocardial Infarction.

This study showed that circulating ketone body levels are associated with functional outcomes after STEMI, supporting the metabolic shift toward ketone utilization as a compensatory mechanism in cardiac injury.

## Abstract (original, from the publication)

BACKGROUND: Circulating ketone bodies (KBs) are increased in patients with heart failure (HF), corresponding with increased cardiac KB metabolism and HF severity. However, the role of circulating KBs in ischemia/reperfusion remains unknown. OBJECTIVES: This study sought to investigate longitudinal changes of KBs and their associations with functional outcomes in patients presenting with ST-segment elevation myocardial infarction (STEMI). METHODS: KBs were measured in 369 participants from a randomized trial on early metformin therapy after STEMI. Nonfasting plasma concentrations of KBs (β-hydroxybutyrate, acetoacetate, and acetone) were measured by nuclear magnetic resonance spectroscopy at presentation, at 24 hours, and after 4 months. Myocardial infarct size and left ventricular ejection fraction (LVEF) were determined by cardiac magnetic resonance imaging at 4 months. Associations of circulating KBs with infarct size and LVEF were determined using multivariable linear regression analyses. RESULTS: Circulating KBs were high at presentation with STEMI (median total KBs: 520 μmol/L; interquartile range [IQR]: 315-997 μmol/L). At 24 hours after reperfusion, KBs were still high compared with levels at 4-month follow-up (206 μmol/L [IQR: 174-246] vs 166 μmol/L [IQR: 143-201], respectively; P < 0.001). Increased KB concentrations at 24 hours were independently associated with larger myocardial infarct size (total KBs, per 100 μmol/L: β = 1.56; 95% confidence interval: 0.29-2.83; P = 0.016) and lower LVEF (β = -1.78; 95% CI: (-3.17 to -0.39; P = 0.012). CONCLUSIONS: Circulating KBs are increased in patients presenting with STEMI. Higher KBs at 24 hours are associated with functional outcomes after STEMI, which suggests a potential role for ketone metabolism in response to myocardial ischemia. (Metabolic Modulation With Metformin to Reduce Heart Failure After Acute Myocardial Infarction: Glycometabolic Intervention as Adjunct to Primary Coronary Intervention in ST Elevation Myocardial Infarction (GIPS-III): a Randomized Controlled Trial; NCT01217307).

Auteurs: Marie-Sophie L Y de Koning, B Daan Westenbrink, Solmaz Assa, Erwin Garcia, Margery A Connelly, Dirk J van Veldhuisen, Robin P F Dullaart, Erik Lipsic, Pim van der Harst

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Bron: Journal of the American College of Cardiology, https://doi.org/10.1016/j.jacc.2021.07.054. Bijgewerkt 2026-07-03T13:28:33Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.