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The relationship between cholesterol and survival in patients with chronic heart failure

Mathias Rauchhaus1, Andrew L Clark, Wolfram Doehner

  • 1Clinical Cardiology, National Heart and Lung Institute, Imperial College School of Medicine, London, United Kingdom.

Journal of the American College of Cardiology
|December 10, 2003
PubMed

Insights

Lower serum total cholesterol is linked to a worse prognosis in patients with chronic heart failure (CHF). Higher cholesterol levels independently predict better survival in CHF patients, regardless of other risk factors.

Area of Science:

  • Cardiology
  • Biochemistry

Background:

  • Elevated lipoprotein levels are recognized cardiovascular risk factors.
  • The prognostic significance of endogenous lipoproteins in chronic heart failure (CHF) remains incompletely understood.

Purpose of the Study:

  • To elucidate the relationship between serum cholesterol levels and survival outcomes in patients diagnosed with chronic heart failure (CHF).

Main Methods:

  • A derivation cohort of 114 patients with CHF was followed for at least 12 months.
  • A validation cohort of 303 unselected CHF patients was used to confirm findings.
  • The association between endogenous lipoproteins and patient survival was analyzed.

Main Results:

  • In the derivation cohort, higher total serum cholesterol independently predicted survival (hazard ratio 0.64).
  • A cholesterol cut-off of ≤5.2 mmol/l best predicted 12-month mortality.
  • In the validation cohort, survival increased by 25% for each mmol/l increment in total cholesterol.

Conclusions:

  • Lower serum total cholesterol is independently associated with a poorer prognosis in patients with chronic heart failure (CHF).
  • Cholesterol's prognostic value in CHF warrants further investigation.
Abstract

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