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

Tiziana Sampietro1, Federico Bigazzi, Mariarita Puntoni

  • 1CNR Institute of Clinical Physiology, Italy bScuola Superiore Sant'Anna, Pisa, Italy. tizisamp@ifc.cnr.it

Journal of Cardiovascular Medicine (Hagerstown, Md.)
|October 3, 2009
PubMed

Insights

Low high-density lipoprotein (HDL)-cholesterol is a significant risk factor for cardiovascular diseases. In patients with left ventricular dysfunction, low HDL-cholesterol independently predicts increased risk of cardiac and all-cause death.

Area of Science:

  • Cardiology
  • Clinical Research
  • Lipid Metabolism

Background:

  • Low high-density lipoprotein (HDL)-cholesterol is a recognized risk factor for cardiovascular diseases.
  • The prognostic significance of HDL-cholesterol in patients with left ventricular dysfunction, particularly when coronary disease is absent, requires further investigation.

Purpose of the Study:

  • To determine the prognostic value of HDL-cholesterol levels in patients diagnosed with left ventricular dysfunction.
  • To assess whether HDL-cholesterol levels predict mortality risk irrespective of the presence of coronary artery disease.

Main Methods:

  • The study cohort comprised 686 consecutive patients hospitalized for left ventricular dysfunction.
  • Patients underwent lipid profiling and coronary angiography, with follow-up for a mean of 23 months to record major adverse events.
  • Multivariable analysis was employed to assess the independent predictors of mortality.

Main Results:

  • Over half the patients (52%) had HDL-cholesterol levels below 40 mg/dl.
  • Low HDL-cholesterol (<40 mg/dl) was associated with a significantly higher risk of cumulative mortality (HR 1.77) and cardiac death (HR 2.06).
  • This association persisted even in patients without significant coronary stenosis, and C-reactive protein improved predictive power.

Conclusions:

  • Lower HDL-cholesterol levels serve as a strong and independent predictor of both cardiac and all-cause mortality in patients with left ventricular dysfunction.
  • The prognostic impact of low HDL-cholesterol is evident regardless of the presence or absence of coronary atherosclerosis.
Abstract

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