Related Experiment Videos

Clinical significance of high-density lipoprotein cholesterol in left-sided infective endocarditis

Gokhan Kahveci1, Fatih Bayrak, Bulent Mutlu

  • 1Department of Cardiology, Rize State Hospital, Rize, Turkey. drmarist@yahoo.co.uk

The American Journal of Cardiology
|April 9, 2008
PubMed

Insights

Low high-density lipoprotein (HDL) cholesterol levels indicate a higher risk of complications in patients with infective endocarditis (IE). Measuring HDL cholesterol at admission can predict clinical outcomes in these patients.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Biochemistry

Background:

  • Decreased serum high-density lipoprotein (HDL) cholesterol is a known prognostic indicator in severe infections.
  • Left-sided infective endocarditis (IE) is a serious condition with potentially severe outcomes.

Purpose of the Study:

  • To investigate serum HDL cholesterol levels as a predictor of clinical outcomes in patients with left-sided IE.
  • To determine if admission HDL cholesterol levels can identify patients at risk for complicated courses.

Main Methods:

  • Retrospective analysis of 54 patients with left-sided IE and available admission serum HDL cholesterol levels.
  • Comparison of HDL cholesterol levels between IE patients and healthy controls.
  • Analysis of HDL cholesterol levels in relation to clinical outcomes (complicated vs. uneventful hospital course).

Main Results:

  • Patients with IE had significantly lower median serum HDL cholesterol levels than healthy controls (26 vs. 47 mg/dl, p < 0.0001).
  • Patients with complicated IE courses had lower median HDL cholesterol levels than those with uneventful courses (24 vs. 36 mg/dl, p = 0.011).
  • A serum HDL cholesterol cut-off of 25 mg/dl demonstrated 62% sensitivity, 75% specificity, and 90% positive predictive value for predicting complicated outcomes.

Conclusions:

  • Admission serum HDL cholesterol levels are significantly reduced in patients with left-sided IE.
  • Low serum HDL cholesterol levels are a valuable predictor of complicated clinical courses in patients with IE.

Related Concept Videos

Endocarditis II: Clinical Features of Infective Endocarditis01:25

Endocarditis II: Clinical Features of Infective Endocarditis

Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
Endocarditis I: Introduction01:25

Endocarditis I: Introduction

Introduction:Endocarditis is the infection of the endocardium, the inner lining of the heart and its valves. When the heart muscle is involved, the condition is termed myocarditis, while an infection of the outer lining is called pericarditis. Infective endocarditis (IE) primarily affects the endocardium, where pathogens adhere to the valves or lining, forming vegetation that can lead to severe complications. Infective endocarditis occurs when microorganisms, usually bacteria from other body...
Endocarditis IV: Nursing Management01:29

Endocarditis IV: Nursing Management

Infective endocarditis (IE) is a chronic infection of the heart's endocardium, primarily affecting the heart valves. A detailed nursing assessment for a patient with IE involves collecting subjective and objective data to ensure an accurate diagnosis and timely intervention.Subjective DataThe nurse gathers information about the patient's symptoms and complaints during the subjective assessment. Patients with infective endocarditis often report non-specific symptoms that can mimic other...
Endocarditis III: Medical Management01:18

Endocarditis III: Medical Management

Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
Rheumatic Heart Disease I: Introduction01:23

Rheumatic Heart Disease I: Introduction

Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
Myocarditis II: Clinical Features and Diagnostic Tests01:27

Myocarditis II: Clinical Features and Diagnostic Tests

Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...