Albert Teis1,2, G Cediel3, N Amigó4,5,6, J Julve6,7, J Aranyó3, J Andrés-Cordón3, C Puig-Jové8, E Castelblanco6,7,9, F Gual-Capllonch3, E Ferrer-Sistach3, N Vallejo3, G Juncà3, J López-Ayerbe3, M De Antonio10, M Domingo10, E Santiago-Vacas10, P Codina10, D Mauricio11,6,7,9,12, J Lupón10, Nuria Alonso13,14,15, A Bayes-Genis3,11,16. 1. Heart Institute, Cardiology Department, Germans Trias University Hospital, Carretera de Canyet s/n, 08916, Badalona, Barcelona, Spain. a_teis@yahoo.es. 2. Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain. a_teis@yahoo.es. 3. Heart Institute, Cardiology Department, Germans Trias University Hospital, Carretera de Canyet s/n, 08916, Badalona, Barcelona, Spain. 4. Biosfer Teslab, SL, Reus, Spain. 5. Metabolomics Platform, Rovira i Virgili University (URV), Instituto de Investigación Sanitaria Pere Virigili (IISPV), Tarragona, Spain. 6. Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, Barcelona, Spain. 7. Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau i Institut d'Investigació Biomèdica de l'Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain. 8. Endocrinology and Nutrition Department, Germans Trias University Hospital, Badalona, Barcelona, Spain. 9. Endocrinology and Nutrition Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. 10. Heart Institute, Heart Failure Unit, Germans Trias University Hospital, Badalona, Barcelona, Spain. 11. Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain. 12. Lleida Biomedical Research Institute's Dr. Pifarré Foundation (IRBLleida), University of Lleida, Lleida, Spain. 13. Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain. nalonso.germanstrias@gencat.cat. 14. Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, Barcelona, Spain. nalonso.germanstrias@gencat.cat. 15. Endocrinology and Nutrition Department, Heart Failure Unit, Hospital Universitari Germans Trias i Pujol, Carretera de Canyet s/n, 08916, Badalona, Barcelona, Spain. nalonso.germanstrias@gencat.cat. 16. Centre for Biomedical Research on cardiovascular Diseases (CIBERCV), Instituto de Salud Carlos III, Barcelona, Spain.
Abstract
Evidence regarding any association of HDL-particle (HDL-P) derangements and HDL-cholesterol content with cardiovascular (CV) death in chronic heart failure (HF) is lacking. To investigate the prognostic value of HDL-P size (HDL-Sz) and the number of cholesterol molecules per HDL-P for CV death in HF patients. Outpatient chronic HF patients were enrolled. Baseline HDL-P number, subfractions and HDL-Sz were measured using 1H-NMR spectroscopy. The HDL-C/P ratio was calculated as HDL-cholesterol over HDL-P. Endpoint was CV death, with non-CV death as the competing event. 422 patients were included and followed-up during a median of 4.1 (0-8) years. CV death occurred in 120 (30.5%) patients. Mean HDL-Sz was higher in CV dead as compared with survivors (8.39 nm vs. 8.31 nm, p < 0.001). This change in size was due to a reduction in the percentage of small HDL-P (54.6% vs. 60% for CV-death vs. alive; p < 0.001). HDL-C/P ratio was higher in the CV-death group (51.0 vs. 48.3, p < 0.001). HDL-Sz and HDL-C/P ratio were significantly associated with CV death after multivariable regression analysis (HR 1.22 [95% CI 1.01-1.47], p = 0.041 and HR 1.04 [95% CI 1.01-1.07], p = 0.008 respectively). HDL-Sz and HDL-C/P ratio are independent predictors of CV death in chronic HF patients.
Evidence regarding any association of class="Chemical">HDL-particle (pan class="Chemical">HDL-P) derangements and HDL-cholesterol content with cardiovascular (CV) death in chronic heart failure (HF) is lacking. To investigate the prognostic value of HDL-P size (HDL-Sz) and the number of cholesterol molecules per HDL-P for CV death in HF patients. Outpatient chronic HF patients were enrolled. Baseline HDL-P number, subfractions and HDL-Sz were measured using 1H-NMR spectroscopy. The HDL-C/P ratio was calculated as HDL-cholesterol over HDL-P. Endpoint was CV death, with non-CV death as the competing event. 422 patients were included and followed-up during a median of 4.1 (0-8) years. CV death occurred in 120 (30.5%) patients. Mean HDL-Sz was higher in CV dead as compared with survivors (8.39 nm vs. 8.31 nm, p < 0.001). This change in size was due to a reduction in the percentage of small HDL-P (54.6% vs. 60% for CV-death vs. alive; p < 0.001). HDL-C/P ratio was higher in the CV-death group (51.0 vs. 48.3, p < 0.001). HDL-Sz and HDL-C/P ratio were significantly associated with CV death after multivariable regression analysis (HR 1.22 [95% CI 1.01-1.47], p = 0.041 and HR 1.04 [95% CI 1.01-1.07], p = 0.008 respectively). HDL-Sz and HDL-C/P ratio are independent predictors of CV death in chronic HF patients.
Authors: John S Gottdiener; James Bednarz; Richard Devereux; Julius Gardin; Allan Klein; Warren J Manning; Annitta Morehead; Dalane Kitzman; Jae Oh; Miguel Quinones; Nelson B Schiller; James H Stein; Neil J Weissman Journal: J Am Soc Echocardiogr Date: 2004-10 Impact factor: 5.251