Association of Serum Zinc Level With Prognosis in Patients With Heart Failure

•Zinc is an intracellular ion, stored mainly in the skeletal muscles and bones, and is associated with cell growth and differentiation as a catalytic and structural cofactor.•Zinc-deficient heart failure (HF) patients experience high cardiac and all-cause mortality accompanied by ongoing myocardial damage (troponin I), inflammation (C-reactive protein), fewer micronutrients (sodium, magnesium, calcium, and iron), and impaired exercise capacity.•Based on these findings, an interventional trial of zinc repletion should be considered to improve outcomes in HF. Zinc is an essential cofactor for energy transfer and physiological heart function, has antioxidant properties, and is involved in multiple signaling pathways. We aimed to investigate the associations between serum zinc levels with prognosis, as well as underlying cardiac function and exercise capacity, in patients with heart failure (HF). We measured serum zinc levels in 968 consecutive hospitalized patients with decompensated HF, who were divided into 3 groups based on serum zinc levels (µg/dL): first (zinc ≥75, n = 323), second (62≤ zinc