Background: The association between metabolic syndrome and the development of heart failure (HF) with preserved ejection fraction (HFpEF) has not been completely clarified.

Aim: To evaluate the association between metabolic syndrome and the risk of HF hospitalization for patients with HFpEF.

Methods: Patient data were obtained from the American cohort of the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial database. Data for the primary outcome (hospitalization for HF) and secondary outcomes (all-cause mortality, cardiovascular mortality, and all-cause hospitalization) were collected, and hazard ratios (HRs) for the patients with and without metabolic syndrome were analyzed by applying a multivariable Cox proportional hazard model.

Results: Among the 1,548 total participants, 1,197 had metabolic syndrome. The patients with metabolic syndrome exhibited worse heart function and a lower quality of life than those without metabolic syndrome. During the 3.3 years of follow-up, 351 patients were hospitalized for HF. After a multivariable adjustment, the risk of hospitalization for HF and all-cause hospitalization (adjusted HR = 1.42, 95% CI: 1.01–2.00; p = 0.042 and adjusted HR = 1.27; 95% CI: 1.04–1.54; p = 0.017, respectively) were independently associated with HFpEF for the patients with metabolic syndrome. In addition, the risks of HF hospitalization and all-cause hospitalization among 267 propensity score-matched patients were higher for patients with metabolic syndrome (HR = 1.53, 95% CI = 1.05–2.23, and p = 0.025 and HR = 1.34, 95% CI = 1.08–1.67, and p = 0.009, respectively).

Conclusion: The risks of HF hospitalization and all-cause hospitalization were higher for patients with HFpEF having metabolic syndrome than for those without metabolic syndrome.

背景： 代谢综合征与射血分数保留的心力衰竭 (HF) 发展 (HFpEF) 之间的关联尚未完全阐明。

目的： 评估代谢综合征与 HFpEF 患者的 HF 住院风险之间的关联。

方法：患者数据来自美国使用醛固酮拮抗剂治疗保留的心脏功能心力衰竭队列 (TOPCAT) 试验数据库。收集了主要结局（因 HF 住院）和次要结局（全因死亡率、心血管死亡率和全因住院）的数据，并通过应用多变量 Cox 比例风险模型。

结果：在总共 1,548 名参与者中，1,197 人患有代谢综合征。与没有代谢综合征的患者相比，代谢综合征患者表现出更差的心脏功能和更低的生活质量。在 3.3 年的随访期间，351 名患者因 HF 住院。多变量调整后，心衰住院风险和全因住院风险（调整后的 HR = 1.42，95% CI：1.01–2.00；磷= 0.042，调整后的 HR = 1.27；95% 置信区间：1.04–1.54；磷= 0.017，分别）与代谢综合征患者的 HFpEF 独立相关。此外，代谢综合征患者的 267 名倾向评分匹配患者的 HF 住院和全因住院风险较高（HR = 1.53，95% CI = 1.05-2.23，和磷 = 0.025 和 HR = 1.34，95% CI = 1.08–1.67，和 磷 = 0.009，分别）。

结论： 患有代谢综合征的 HFpEF 患者的 HF 住院和全因住院风险高于没有代谢综合征的患者。