Lower low density lipoprotein cholesterol associates to higher mortality in non-diabetic heart failure patients

• DOI: 10.1016/j.ijcrp.2023.200197
• Publication Date: 2023-07-16T21:19:58Z
• Authors: R. Gouveia; S. Madureira; C. Elias; A. Neves; P. Ribeirinho Soares; M. Soares-Carreira; J. Pereira; A. Ribeiro; M. Amorim; J. Almeida; J.P. Araújo; P. Lourenco
• Keywords: 03 medical and health sciences; 0302 clinical medicine; RC666-701; Diseases of the circulatory (Cardiovascular) system; Heart failure; LDL-c; Cholesterol paradox; Research Paper

In patients with established heart failure (HF) low total cholesterol levels associate worse prognosis. Evidence concerning the impact of Low-density lipoprotein (LDL-c) in HF is scarce. We aimed to evaluate prognostic LDL-c HF, both and without diabetes mellitus (DM). retrospectively analyzed outpatients chronic systolic dysfunction followed our clinic from January/2012 May/2018. was calculated using Friedewald's formula. Patients a complete lipid profile were excluded. The endpoint under analysis all-cause mortality. until January/2021. A Cox-regression used study LDL-c. cut-off 100 mg/dL (mean value). Analysis stratified according coexistence DM. Multivariate models built adjusting for age, sex, coronary artery disease, atherosclerotic non-coronary arterial hypertension, smoking status, statin use, severity dysfunction, creatinine clearance evidence-based therapy. studied 522 patients, mean age 70 years, 66.5% males. Severe present 42.7%, 30.5% had 60.5% 41.6% 92.0% treated beta blocker, 87.5% an ACEi/ARB 29.1% MRA. During median follow-up 53 (interquartile range 33–73) months, 235 (45%) died. ≤100 presented increased multivariate-adjusted risk mortality: HR = 1.58 (95% CI: 1.08–2.30), p 0.02. When DM, independently associated death – 1.55 CI:1.05–2.30), 0.03 DM; DM no association detected 1.18 0.77–1.80), 0.44. Non-DM LDL-c>100 have 35% reduction mortality when compared those lower values. "cholesterol paradox" also applies non-DM patients.