Related Experiment Video
Updated: Jul 1, 2025
Author Spotlight: Exploring the Relationship Between Lipotoxicity and HFpEF
Published on: March 29, 2024
Low-density lipoprotein cholesterol, erythrocyte, and platelet in heart failure with preserved ejection fraction
Masamichi Yano1, Masami Nishino1, Shodai Kawanami1
1Division of Cardiology, Osaka Rosai Hospital, Osaka, Japan.
Insights
A new LEP score combining low-density lipoprotein cholesterol (LDL-C), anemia, and low platelets predicts worse outcomes in heart failure with preserved ejection fraction (HFpEF) patients. Higher LEP scores indicate increased risk for death and hospital readmission.
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.
Aims:
Low-density lipoprotein cholesterol (LDL-C), anaemia and low platelets have been associated with worse clinical outcomes in heart failure patients. We investigated the relationship between the combination of these three components and clinical outcome in patients with heart failure with preserved ejection fraction (HFpEF).
Methods And Results:
We examined the data of 1021 patients with HFpEF hospitalized with acute decompensated heart failure (HF) from the PURSUIT-HFpEF registry, a prospective, multicenter observational study. The enrolled patients were classified into four groups by an LEP (LDL-C, Erythrocyte, and Platelet) score of 0 to 3 points, with 1 point each for LDL-C, erythrocyte and platelet values less than the cut-off values as calculated by receiver operating characteristic curve analysis. The endpoint, a composite of all-cause death and HF readmission, was evaluated among the four groups. Median follow-up duration was 579 [300, 978] days. Risk of the composite endpoint significantly differed among the four groups (P < 0.001). Kaplan-Meier analysis showed that the groups with an LEP score of 2 had higher risk of the composite endpoint than those with an LEP score of 0 or 1 (P < 0.001, and P = 0.013, respectively), while those with an LEP score of 3 had higher risk than those with an LEP score of 0, 1 or 2 (P < 0.001, P < 0.001 and P = 0.020, respectively). Cox proportional hazards analysis showed that an LEP score of 3 was significantly associated with the composite endpoint (P = 0.030). Kaplan-Meier analysis showed that risk of the composite of all-cause death and HF readmission was significantly higher in low LDL values (less than the cut-off values as calculated by receiver operating characteristic curve analysis) patients with statin use than in those without statin use (log rank P = 0.002).
Conclusions:
LEP score, which comprehensively reflects extra-cardiac co-morbidities, is significantly associated with clinical outcomes in HFpEF patients.
More Related Videos
Related Concept Videos
01:17Pathophysiology of Heart Failure
01:25Blood Studies for Cardiovascular System III: Serum Lipid Profile
Serum lipids are fats and fatty substances in the blood and are crucial for various bodily functions, including energy storage, cellular structure, and hormone production. Serum lipids consist of cholesterol, triglycerides, and phospholipids.
Cholesterol is a soft, fat-like substance found in all body cells. It is crucial for producing hormones, vitamin D, and substances that aid...
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
01:26Imbalances in Cardiac Output
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
01:31Lipid-derived Compounds in the Human Body
Fat-soluble Vitamins
Fat-soluble vitamins, including vitamins A, D, E, and K, are required in minimal quantities, but their deficiencies can lead to severely abnormal physiological conditions. For example, vitamin A deficiency can cause night blindness, dry skin,...
01:22Heart Failure Drugs: Diuretics