Intermountain Medical Center Heart Institute, Salt Lake City, UT 84107, USA.
Division of Cardiovascular Medicine, Department of Medicine, Stanford University, Stanford, CA 94305, USA.
Nutrients. 2024 Jun 28;16(13):2075. doi: 10.3390/nu16132075.
Periodic fasting was previously associated with greater longevity and a lower incidence of heart failure (HF) in a pre-pandemic population. In patients with coronavirus disease 2019 (COVID-19), periodic fasting was associated with a lower risk of death or hospitalization. This study evaluated the association between periodic fasting and HF hospitalization and major adverse cardiovascular events (MACEs).
Patients enrolled in the INSPIRE registry from February 2013 to March 2020 provided periodic fasting information and were followed into the pandemic ( = 5227). Between March 2020 and February 2023, = 2373 patients were studied, with = 601 COVID-positive patients being the primary study population (2836 had no COVID-19 test; 18 were excluded due to fasting <5 years). A Cox regression was used to evaluate HF admissions, MACEs, and other endpoints through March 2023, adjusting for covariables, including time-varying COVID-19 vaccination.
In patients positive for COVID-19, periodic fasting was reported by 180 (30.0% of 601), who periodically fasted over 43.1 ± 19.2 years (min: 7, max: 83). HF hospitalization ( = 117, 19.5%) occurred in 13.3% of fasters and 22.1% of non-fasters [adjusted hazard ratio (aHR) = 0.63, CI = 0.40, 0.99; = 0.044]. Most HF admissions were exacerbations, with a prior HF diagnosis in 111 (94.9%) patients hospitalized for HF. Fasting was also associated with a lower MACE risk (aHR = 0.64, CI = 0.43, 0.96; = 0.030). In = 1772 COVID-negative patients (29.7% fasters), fasting was not associated with HF hospitalization (aHR = 0.82, CI = 0.64, 1.05; = 0.12). In COVID-positive and negative patients combined, periodic fasting was associated with lower mortality (aHR = 0.60, CI = 0.39, 0.93; = 0.021).
Routine periodic fasting was associated with less HF hospitalization in patients positive for COVID-19.
在大流行前的人群中，间歇性禁食与更高的寿命和更低的心力衰竭（HF）发生率相关。在 2019 年冠状病毒病（COVID-19）患者中，间歇性禁食与死亡或住院风险降低相关。本研究评估了间歇性禁食与 HF 住院和主要不良心血管事件（MACEs）之间的关系。
2013 年 2 月至 2020 年 3 月期间，INSPIRE 登记处招募的患者提供了间歇性禁食信息，并在大流行期间（n=5227）进行了随访。2020 年 3 月至 2023 年 2 月期间，研究了 n=2373 例患者，其中 n=601 例 COVID-19 阳性患者为主要研究人群（n=2836 例未进行 COVID-19 检测；n=18 例因禁食<5 年而被排除）。使用 Cox 回归评估了 HF 入院、MACE 和其他终点，通过 2023 年 3 月进行调整，包括时变 COVID-19 疫苗接种等协变量。
在 COVID-19 阳性患者中，有 180 例（601 例的 30.0%）报告周期性禁食，他们周期性禁食超过 43.1±19.2 年（最小：7 岁，最大：83 岁）。HF 住院（n=117，19.5%）在禁食者中的发生率为 13.3%，而非禁食者中的发生率为 22.1%[调整后的危险比（aHR）=0.63，CI=0.40，0.99；p=0.044]。大多数 HF 入院是病情加重，在因 HF 住院的 111 例患者中（94.9%）有 HF 既往诊断。禁食也与较低的 MACE 风险相关（aHR=0.64，CI=0.43，0.96；p=0.030）。在 n=1772 例 COVID-19 阴性患者（29.7%的禁食者）中，禁食与 HF 住院无关（aHR=0.82，CI=0.64，1.05；p=0.12）。在 COVID-19 阳性和阴性患者中，周期性禁食与死亡率降低相关（aHR=0.60，CI=0.39，0.93；p=0.021）。
在 COVID-19 阳性患者中，常规周期性禁食与 HF 住院减少相关。
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