Effects of ketone bodies supplementation in patients with heart failure: A systematic review and meta-analysis

Table 1 Baseline Characteristics of included studies, n (%)

Trials	Country	Patient population	Intervention	Sample size (n)	Gender (M/F)	Age, years	BMI, kg/m2	HR, bpm	SBP, mmHg	DBP, mmHg	LVEF, %	NT-proBNP, ng/L	HbA1c, mmol/mol	eGFR, mL	Medications
Nielsen et al[14], 2019	Denmark	Patients with HFrEF (LVEF ≤ 40%), NYHA class II-III, and on stable guideline-directed therapy	3-hydroxybutyrate infusion	34	31/3	60	26	65	130	77	36	617	39	77	ACE inhibitor/ARB/ARNI: 15 (94)
															Platelet inhibitors: 12 (75)
															Beta Blockers: 16 (100)
															Diuretics: 8 (50)
															MRA: 10 (63)
Berg-Hansen et al[12], 2024	Denmark	Stable HFrEF patients (LVEF ≤ 40%), NYHA class II-III, receiving optimal medical therapy at an outpatient HF clinic	Oral ketone ester drink	24	17/7	65	30	63	124	75	33	609	5.8	50	ACE inhibitor/ARB/ARNI: 24 (100). MRA: 19 (79)
Gopalasingam et al[11], 2023	Denmark	HFrEF patients (LVEF ≤ 40%), NYHA class II-III, and no recent history of MI	3-hydroxybutyrate infusion	12	11/1	64	N/A	72	120	76	33	360	41	85	ACE inhibitor/ARB/ARNI: 24 (100)
															Platelet inhibitors: 14 (58)
															Beta blockers: 16 (100)
															Diuretics: 21 (88)
															MRA: 19 (79)
Gopalasingam et al[22], 2024	Denmark	Patients with HFpEF (LVEF > 40%), T2D, and diastolic dysfunction, with either LV hypertrophy (≥ 12 mm) or a history of MI	Oral ketone ester drink	24	22/2	64	30	76	135	81	52	100	51	77	ACE inhibitor/ARB/ARNI: 8 (67)
															Platelet inhibitors: 4 (33)
															Beta blockers: 7 (58)
															Diuretics: 11 (92)
															MRA: 10 (63)

Data are reported as mean ± SD or median (interquartile range). M: Male; F: Female; eGFR: Estimated glomerular filtration rate; BMI: Body mass index; HR: Heart rate; SBP: Systolic blood pressure; DBP: Diastolic blood pressure; NT-proBNP: N-terminal pro brain-natriuretic-peptide; HbA1c: Hemoglobin A1c; HFrEF: Heart failure with reduced ejection fraction; LVEF: Left ventricular ejection fraction; NYHA: New York Heart Association; ACE: Angiotensin-converting enzyme; ARB: Angiotensin-2 receptor blockers; ARNI: Angiotensin receptor-neprilysin inhibitor; MRA: Mineralocorticoid receptor antagonists; LV: Left ventricular; MI: Myocardial infarction; N/A: Not applicable; T2D: Type-2 diabetes.