Circulating branched-chain amino acids (BCAAs) are linked with mortality in population-based studies. Whether they also predict mortality in patients with established cardiovascular disease (CVD) is unclear. We therefore determined serum BCAAs by NMR spectroscopy in 327 patients with established CVD. Prospectively, deaths were recorded over a mean follow-up period of 8.1±3.5 years. At baseline, serum valine, leucine and isoleucine were significantly associated with T2DM (all p-values <0.001). Prospectively, death occurred in 49.5% of patients with T2DM and in 37.2% nondiabetic patients (p=0.036). Table 1 shows the associations of BCAAs with mortality univariately and after multivariate adjustment including presence of T2DM in the total study cohort as well as separately for patients with T2DM and for nondiabetic patients. Low valine as well as low leucine predicted mortality independently from the presence of T2DM in the total cohort and, in subgroup analysis, specifically in patients with T2DM. We conclude that low valine and leucine serum levels predict mortality in patients with established CVD independently from the presence of T2DM.


A. Muendlein: None. A. Leiherer: None. C.H. Saely: None. A. Vonbank: None. B. Larcher: None. A. Mader: None. P. Fraunberger: None. H. Drexel: None.

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