Cholesterol Content of Very-Low-Density Lipoproteins Is Associated with 1-Year Mortality in Acute Heart Failure Patients

Biomolecules. 2022 Oct 21;12(10):1542. doi: 10.3390/biom12101542.

Abstract

Considering the relationship between the extent of metabolic derangement and the disease severity in heart failure, we hypothesized that the lipid content of very-low-density lipoprotein (VLDL) may have prognostic value for 1 year mortality in acute heart failure (AHF). Baseline serum levels of VLDL cholesterol (VLDL-C), VLDL triglycerides (VLDL-TG), VLDL phospholipids (VLDL-PL), and VLDL apolipoprotein B (VLDL-apoB) were measured using NMR spectroscopy. We calculated the ratios of the respective VLDL lipids and VLDL apoB (VLDL-C/VLDL-apoB, VLDL-TG/VLDL-apoB, and VLDL-PL/VLDL-apoB), as estimators of the cholesterol, triglyceride, and phospholipid content of VLDL particles and tested their association with mortality. Out of 315 AHF patients, 118 (37.5%) patients died within 1 year after hospitalization for AHF. Univariable Cox regression analyses revealed a significant inverse association of VLDL-C/VLDL-apoB (hazard ratio (HR) 0.43, 95% confidence interval (CI) 0.29−0.64, p < 0.001), VLDL-TG/VLDL-apoB (HR 0.79, 95% CI 0.71−0.88, p < 0.001), and VLDL-PL/VLDL-apoB (HR 0.37, 95% CI 0.25−0.56, p < 0.001) with 1 year mortality. Of the tested parameters, only VLDL-C/VLDL-apoB remained significant after adjustment for age and sex, as well as other clinical and laboratory parameters that showed a significant association with 1 year mortality in the univariable analyses. We conclude that cholesterol content of circulating VLDL (VLDL-C/VLDL-apoB) might be of prognostic value in AHF.

Keywords: NMR spectroscopy; acute heart failure; cholesterol; mortality; prognostic biomarkers; risk; very-low-density lipoprotein.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Apolipoproteins B
  • Cholesterol
  • Cholesterol, VLDL
  • Heart Failure*
  • Humans
  • Lipoproteins, VLDL* / chemistry
  • Lipoproteins, VLDL* / metabolism
  • Phospholipids
  • Triglycerides

Substances

  • Cholesterol, VLDL
  • Lipoproteins, VLDL
  • Cholesterol
  • Triglycerides
  • Apolipoproteins B
  • Phospholipids

Grants and funding

This research was funded by the Austrian Science Fund (FWF) (P27166-B23 to S.F.). T.M. was supported by Austrian Science Fund (FWF) grants P28854, I3792, DOC-130, and DK-MCD W1226, Austrian Research Promotion Agency (FFG) grants 864690 and 870454, the Integrative Metabolism Research Center Graz, the Austrian Infrastructure Program 2016/2017, the Styrian Government (Zukunftsfonds, doc.fund program), the City of Graz, and BioTechMed-Graz (flagship project).