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Life sciences · Journal article
Russian Journal of Cardiology · September 23, 2026
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Aim. To assess the prevalence of individual components of metabolic syndrome (MS), the incidence of MS, and its clinical and prognostic significance in outpatients with heart failure (HF). Material and methods. This retrospective analysis of data from the PRIORITY-HF multicenter registry study of patients with HF in the Russian Federation was conducted. The analytical cohort included 19939 patients, and the primary and secondary criteria of MS were analyzed. A group with MS was identified according to diagnostic criteria, and combinations of components were assessed. In addition, cluster analysis was performed, and prognosis was evaluated. Results. In the analyzed cohort, the primary criteria of MS were identified with high frequency as follows: obesity in 45,6%, HTN in 89%, and type 2 diabetes in 27,4% of patients. Among the additional criteria, the highest prevalence was observed for dyslipidemia/lipid-lowering therapy in 80,7%, impaired renal function/damage in 62%, and hyperuricemia/urate-lowering therapy in only 5% of patients. MS was diagnosed in 14403 (70,4%) patients. Among patients with MS, the following distribution was noted depending on the burden of main criteria: 48,8% — 2, 28% — 1, and 23,2% — 3 main criteria. The most frequent combination was HTN + dyslipidemia/lipid-lowering therapy + impaired renal function/damage both in the overall cohort with MS and in the subgroups by left ventricular ejection fraction. Patients with HF with preserved ejection fraction, compared with other phenotypes, had a higher frequency of combinations with 3 main criteria in the composition. Patients with metabolic syndrome (MS) had a significantly higher risk of hospitalization for cardiovascular causes (odds ratio 1,142, 95% confidence interval 1,033-1,263) than patients without MS (p=0,01). Among the identified MS clusters, cluster 1 was characterized by older patient age, a greater burden of kidney impairment/damage, and the poorest prognosis. Conclusion. A high prevalence of individual MS components was found among patients with heart failure. MS was diagnosed in 70,4% of cases. The broad profile of the obtained combinations of MS components reflects the diversity of metabolic disorders in HF patients. MS was associated with a significantly increased risk of hospitalization for cardiovascular causes compared to patients without MS. Cluster analysis demonstrated heterogeneity of patients with MS in clinical characteristics and prognosis.