Low-density lipoprotein cholesterol, erythrocyte, and platelet in heart failure with preserved ejection fraction

Area of Science:

• Cardiology
• Internal Medicine
• Clinical Research

Background:

• Low-density lipoprotein cholesterol (LDL-C), anemia, and low platelets are linked to adverse outcomes in heart failure (HF) patients.
• Heart failure with preserved ejection fraction (HFpEF) represents a significant clinical challenge with limited targeted therapies.

Purpose of the Study:

• To investigate the prognostic value of a combined score of LDL-C, erythrocyte count (anemia), and platelet count in patients with HFpEF.
• To assess the association between this composite score and clinical outcomes, including all-cause death and HF readmission.

Main Methods:

• Analysis of 1021 patients with HFpEF from the prospective, multicenter PURSUIT-HFpEF registry.
• Patients were stratified into four groups based on an LEP (LDL-C, Erythrocyte, Platelet) score (0-3 points).
• Kaplan-Meier and Cox proportional hazards analyses were used to evaluate the composite endpoint of all-cause death and HF readmission.

Main Results:

• The risk of the composite endpoint significantly differed across the four LEP score groups (P < 0.001).
• Patients with LEP scores of 2 and 3 exhibited significantly higher risks of the composite endpoint compared to those with scores of 0 or 1.
• An LEP score of 3 was independently associated with the composite endpoint (P = 0.030).
• Low LDL-C levels were associated with increased risk of adverse outcomes, even in patients using statins.

Conclusions:

• The LEP score, integrating LDL-C, erythrocyte, and platelet levels, serves as a valuable tool for assessing prognosis in HFpEF patients.
• This score comprehensively reflects extra-cardiac comorbidities and their impact on clinical outcomes in HFpEF.
• The findings highlight the importance of monitoring these hematological and lipid parameters in HFpEF management.