Document Detail


High-density lipoprotein cholesterol levels and prognosis in advanced heart failure.
MedLine Citation:
PMID:  19716038     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Mandeep R Mehra; Patricia A Uber; Carl J Lavie; Richard V Milani; Myung H Park; Hector O Ventura
Related Documents :
21458598 - Effect of trans fatty acid isomers from ruminant sources on risk factors of cardiovascu...
11469968 - Hyperlipidemia in chronic cholestatic liver disease.
2679028 - Clinical significance of plasma lipid levels.
20583538 - Adiposity, physical activity and blood lipid profile in 13-year-old adolescents.
2573458 - The influence of multiple photoperiods and pinealectomy on gonads, pelage and body weig...
12943298 - Comparison of peanut meal and soybean meal as protein supplements for laying hens.
Publication Detail:
Type:  Journal Article    
Journal Detail:
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:
Created Date:  2009-08-31     Completed Date:  2010-01-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9102703     Medline TA:  J Heart Lung Transplant     Country:  United States    
Other Details:
Languages:  eng     Pagination:  876-80     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA. mmehra@medicine.umaryland.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
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:
0/Cholesterol, HDL; 635-65-4/Bilirubin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Gastroesophageal reflux in bronchiolitis obliterans syndrome: a new perspective.
Next Document:  Low thromboembolism and pump thrombosis with the HeartMate II left ventricular assist device: analys...