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Impaired High-Density Lipoprotein Anti-Oxidative Function Is Associated With Outcome in Patients With Chronic Heart

Lore Schrutka1, Klaus Distelmaier1, Philipp Hohensinner1

  • 1Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Austria.

Journal of the American Heart Association
|December 23, 2016
PubMed

Insights

Impaired antioxidative function of high-density lipoprotein (HDL) predicts mortality in chronic heart failure (CHF) patients. Measuring HDL oxidative index (HOI) improves risk prediction for cardiovascular events.

Area of Science:

  • Cardiology
  • Biochemistry
  • Oxidative Stress Research

Background:

  • Oxidative stress is a key factor in chronic heart failure (CHF) pathogenesis.
  • Antioxidative functions of high-density lipoprotein (HDL) are impaired in patients with ischemic cardiomyopathy.
  • The clinical impact of antioxidative HDL function on CHF patient outcomes remains unclear.

Purpose of the Study:

  • To investigate the predictive value of antioxidative HDL function on mortality in a CHF patient cohort.
  • To determine if HDL oxidative index (HOI) can predict cardiovascular events in CHF patients.

Main Methods:

  • Prospective enrollment of 320 consecutive CHF patients.
  • Determination of antioxidative HDL function using the HDL oxidative index (HOI).
  • Median follow-up of 2.8 years, monitoring cardiovascular endpoints and mortality.

Main Results:

  • An HOI ≥1 was significantly associated with survival free of cardiovascular events (HR 2.28, P<0.001).
  • This association remained significant after multivariable adjustment (adjusted HR 1.83, P=0.012).
  • HOI determination significantly improved risk prediction beyond N-terminal pro-B-type natriuretic peptide (NT-proBNP).

Conclusions:

  • Impaired antioxidative HDL function is a strong, independent predictor of mortality in CHF.
  • The HOI measurement substantially improves risk prediction in CHF patients.
  • HOI offers valuable prognostic information for managing chronic heart failure.
Abstract

Keywords:
heart failurehigh‐density lipoprotein cholesteroloxidative stressprognosis

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