Particle size and cholesterol content of circulating HDL correlate with cardiovascular death in chronic heart failure

Sci Rep. 2021 Feb 4;11(1):3141. doi: 10.1038/s41598-021-82861-6.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Biomarkers / chemistry
  • Cardiovascular System / metabolism
  • Cardiovascular System / physiopathology
  • Cholesterol, HDL / blood*
  • Cholesterol, HDL / chemistry
  • Chronic Disease
  • Cohort Studies
  • Female
  • Heart Failure / blood*
  • Heart Failure / diagnosis*
  • Heart Failure / mortality
  • Heart Failure / physiopathology
  • Humans
  • Magnetic Resonance Spectroscopy
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Outpatients
  • Particle Size*
  • Prognosis
  • Survival Analysis

Substances

  • Biomarkers
  • Cholesterol, HDL