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Impaired High-Density Lipoprotein Function in Patients With Heart Failure
Johanna E Emmens1, Congzhuo Jia2,3, Leong L Ng4,5
1Department of Cardiology University of Groningen Groningen The Netherlands.
Journal of the American Heart Association
|April 19, 2021
Summary
In heart failure patients, higher high-density lipoprotein (HDL) cholesterol efflux predicts lower mortality. HDL function, particularly cholesterol efflux, offers prognostic value beyond HDL cholesterol levels.
Area of Science:
- Cardiology
- Biochemistry
- Proteomics
Background:
- Low high-density lipoprotein (HDL) cholesterol predicts mortality in heart failure.
- HDL proteome composition may explain this association.
- The role of HDL function in heart failure prognosis remains unclear.
Purpose of the Study:
- To investigate the association between HDL function and prognosis in heart failure patients.
- To explore the relationship between HDL functionality and HDL proteome composition.
- To assess changes in HDL function over time in heart failure.
Main Methods:
- Measured HDL cholesterol efflux, antioxidative, and anti-inflammatory capacities in 446 heart failure patients.
- Assessed HDL functionality and proteome composition in 86 patients.
- Followed patients for mortality and hospitalization events.
Main Results:
- HDL cholesterol efflux and anti-inflammatory capacity declined over 9 months.
- Antioxidative capacity increased over 9 months.
- Higher baseline HDL cholesterol efflux was independently associated with lower mortality (HR, 0.81; P=0.001).
- Apolipoprotein A1 was the main HDL protein associated with functionality.
Conclusions:
- HDL cholesterol efflux is a significant independent predictor of mortality in heart failure.
- HDL function metrics provide additional prognostic information beyond HDL cholesterol levels.
- HDL function declines over time in heart failure patients.
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