Low high-density lipoprotein predicts death in patients with mild left ventricular dysfunction regardless of coronary atherosclerosis.

Abstract

OBJECTIVE:

Low plasma high-density lipoprotein (HDL)-cholesterol is a major risk factor for cardiovascular diseases. We investigated whether HDL-cholesterol levels had a prognostic value in patients with mild left ventricular dysfunction, irrespective of the presence of coronary disease.

METHODS:

The study included 686 consecutive patients hospitalized between January 2002 and December 2006 because of left ventricular dysfunction. All patients completed a lipid profile and underwent coronary angiography. Patients were followed for a mean period of 23 months, during which major events were recorded.

RESULTS:

Seventy-three percent of patients were New York Heart Association (NYHA) class I-II, with the mean values of left ventricular ejection fraction and left ventricular end-diastolic diameter being, respectively, 36.3 +/- 8.6% and 58.3 +/- 7.9 mm. Half of the patients (52%) had HDL values less than 40 mg/dl, 28% presented with HDL less than 35 mg/dl. In multivariable analysis, patients with HDL-cholesterol concentration less than 40 mg/dl showed higher risk for cumulative mortality (HR 1.77, P < 0.05) and for cardiac death (HR 2.06, P < 0.05). This higher risk was also observed in patients with low HDL-cholesterol levels but without significant coronary stenosis. The inclusion of the C-reactive protein (CRP) inflammation marker into the model highly improved the power of death prediction.

CONCLUSION:

In patients with left ventricular dysfunction, regardless of the presence of coronary atherosclerosis, lower HDL-cholesterol was a strong and independent predictor of both cardiac and all-cause death.

• Authors: Tiziana Sampietro, Federico Bigazzi, Mariarita Puntoni, Fabrizio Minichilli, Patrizia Landi, Beatrice Dal Pino, Clara Carpeggiani, Antonio L'Abbate
• Journal: Journal of cardiovascular medicine (Hagerstown, Md.) (J Cardiovasc Med (Hagerstown)) Vol. 10 Issue 12 Pg. 898-905 (Dec 2009) ISSN: 1558-2035 [Electronic] United States
• PMID: 19797975 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers
• Lipoproteins, HDL
• C-Reactive Protein

Topics

• Aged
• Biomarkers (blood)
• C-Reactive Protein (metabolism)
• Coronary Artery Disease (blood, complications, mortality)
• Female
• Humans
• Italy (epidemiology)
• Lipoproteins, HDL (blood)
• Male
• Middle Aged
• Prospective Studies
• Risk Factors
• Ventricular Dysfunction, Left (blood, complications, mortality)