Abstract | BACKGROUND: METHODS: We prospectively evaluated the prognostic relationship of HDL levels in severe HF by examining 132 consecutive patients listed for heart transplantation (52 +/- 11 years of age, 80% men, 79% white, mean follow-up 18 months). Using population mean HDL levels (HDL <33 mg/dl [n = 47] vs > or =33 mg/dl [n = 85]), patients were grouped and followed for the primary composite end-points of HF hospitalizations or death, stratified by underlying etiology (non-ischemic, n = 52; ischemic, n = 80). RESULTS: Patients with HDL <33 mg/dl had lower serum sodium (135 vs 137 mEq/liter, p = 0.008), higher total bilirubin (1.3 vs 0.7 mg/dl, p < 0.001) and higher uric acid (7.6 vs 6.7 mg/dl, p = 0.048) levels, but similar serum creatinine compared with the > or =33 mg/dl HDL group. Survival analysis, using a Cox proportional hazards model, revealed reduced HDL (<33 mg/dl) as the most significant independent predictor of HF hospitalizations or death, independent of underlying etiology. Low- cholesterol and low-density lipoprotein ( LDL)-cholesterol alone were not found to be independently predictive of outcome. CONCLUSIONS: Lower HDL levels correlate with adverse prognosis independent of etiology and predict clinical worsening or death in advanced HF. Further study is warranted as to whether these findings represent a clinical marker or suggest a potential therapeutic target.
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Authors | Mandeep R Mehra, Patricia A Uber, Carl J Lavie, Richard V Milani, Myung H Park, Hector O Ventura |
Journal | The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
(J Heart Lung Transplant)
Vol. 28
Issue 9
Pg. 876-80
(Sep 2009)
ISSN: 1557-3117 [Electronic] United States |
PMID | 19716038
(Publication Type: Journal Article)
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Chemical References |
- Cholesterol, HDL
- Bilirubin
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Topics |
- Adult
- Bilirubin
- Cholesterol, HDL
(blood)
- Cohort Studies
- Disease-Free Survival
- Female
- Follow-Up Studies
- Heart Failure
(blood, etiology, mortality, surgery)
- Heart Transplantation
(mortality, physiology)
- Humans
- Male
- Middle Aged
- Patient Selection
- Predictive Value of Tests
- Prognosis
- Prospective Studies
- Time Factors
- Ventricular Dysfunction, Left
(blood, physiopathology, surgery)
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