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Published on: May 16, 2020

High-density lipoprotein cholesterol levels and prognosis in non-ischemic dilated cardiomyopathy

Chao Gong1, Mengmeng Zhou2, Shenzhen Gong1

  • 1Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Frontiers in Endocrinology
|July 11, 2026
PubMed

Insights

Lower high-density lipoprotein cholesterol (HDL-C) levels are linked to worse outcomes in non-ischemic dilated cardiomyopathy (DCM). This readily available biomarker can help identify patients at higher risk for adverse events.

Area of Science:

  • Cardiology
  • Biomarkers
  • Heart Failure Research

Background:

  • Low high-density lipoprotein cholesterol (HDL-C) is linked to poor heart failure outcomes.
  • The prognostic value of HDL-C in non-ischemic dilated cardiomyopathy (DCM) is not well-defined.

Purpose of the Study:

  • To investigate the association between HDL-C levels and long-term clinical outcomes in patients with DCM.
  • To determine if HDL-C can serve as a prognostic biomarker in non-ischemic DCM.

Main Methods:

  • Retrospective enrollment of 297 DCM patients who underwent cardiac magnetic resonance.
  • Assessment of primary (mortality, heart transplantation) and secondary (heart failure readmission) endpoints.
  • Analysis using Kaplan-Meier, Cox regression, and restricted cubic spline (RCS) models.

Main Results:

  • Higher HDL-C levels correlated with significantly better event-free survival for both primary and secondary endpoints.
  • Lower HDL-C was independently associated with increased risk of adverse outcomes.
  • The association was partly attenuated after adjusting for pulmonary hypertension markers.

Conclusions:

  • Lower HDL-C levels are independently associated with adverse outcomes in non-ischemic DCM.
  • HDL-C may serve as a valuable, accessible prognostic biomarker for risk stratification in DCM patients.
Abstract

Keywords:
cardiac magnetic resonancedilated cardiomyopathyhigh-density lipoprotein cholesterolprognosispulmonary hypertension

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