| High-density lipoprotein cholesterol levels and prognosis in advanced heart failure. | |
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MedLine Citation:
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PMID: 19716038 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: High-density lipoproteins (HDLs) influence the generation of prostacyclin via cyclooxygenase stimulation. Prostaglandins represent an important compensatory pathway in advanced heart failure (HF). Whether HDL levels discriminate prognosis in HF remains unknown. METHODS: We prospectively evaluated the prognostic relationship of HDL levels in severe HF by examining 132 consecutive patients listed for heart transplantation (52 +/- 11 years of age, 80% men, 79% white, mean follow-up 18 months). Using population mean HDL levels (HDL <33 mg/dl [n = 47] vs > or =33 mg/dl [n = 85]), patients were grouped and followed for the primary composite end-points of HF hospitalizations or death, stratified by underlying etiology (non-ischemic, n = 52; ischemic, n = 80). RESULTS: Patients with HDL <33 mg/dl had lower serum sodium (135 vs 137 mEq/liter, p = 0.008), higher total bilirubin (1.3 vs 0.7 mg/dl, p < 0.001) and higher uric acid (7.6 vs 6.7 mg/dl, p = 0.048) levels, but similar serum creatinine compared with the > or =33 mg/dl HDL group. Survival analysis, using a Cox proportional hazards model, revealed reduced HDL (<33 mg/dl) as the most significant independent predictor of HF hospitalizations or death, independent of underlying etiology. Low-cholesterol and low-density lipoprotein (LDL)-cholesterol alone were not found to be independently predictive of outcome. CONCLUSIONS: Lower HDL levels correlate with adverse prognosis independent of etiology and predict clinical worsening or death in advanced HF. Further study is warranted as to whether these findings represent a clinical marker or suggest a potential therapeutic target. |
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Authors:
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Mandeep R Mehra; Patricia A Uber; Carl J Lavie; Richard V Milani; Myung H Park; Hector O Ventura |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation Volume: 28 ISSN: 1557-3117 ISO Abbreviation: J. Heart Lung Transplant. Publication Date: 2009 Sep |
Date Detail:
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Created Date: 2009-08-31 Completed Date: 2010-01-11 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9102703 Medline TA: J Heart Lung Transplant Country: United States |
Other Details:
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Languages: eng Pagination: 876-80 Citation Subset: IM |
Affiliation:
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Division of Cardiology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA. mmehra@medicine.umaryland.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Bilirubin Cholesterol, HDL / blood* Cohort Studies Disease-Free Survival Female Follow-Up Studies Heart Failure / blood*, etiology, mortality, surgery Heart Transplantation / mortality, physiology* Humans Male Middle Aged Patient Selection Predictive Value of Tests Prognosis* Prospective Studies Time Factors Ventricular Dysfunction, Left / blood, physiopathology, surgery |
| Chemical | |
Reg. No./Substance:
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0/Cholesterol, HDL; 635-65-4/Bilirubin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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