Low levels of low-density lipoprotein cholesterol: a negative predictor of survival in elderly patients with advanced heart failure.
OBJECTIVE
There are conflicting reports on the role of cholesterol as an adverse prognostic predictor in patients with heart failure (HF). This study aimed to examine the impact of low levels of low-density lipoprotein cholesterol (LDL-c) on cardiac mortality in a cohort of elderly patients with moderate and severe HF.


METHODS
Chronic HF patients from the HF Unit at the Tel-Aviv Medical Center (n = 212, 77% males) with an average NYHA classification of 2.8, a mean age of 76.9 ± 7.3 years (range 66-91) and a mean follow-up of 3.7 years were consecutively enrolled. The cohort was divided into tertiles according to LDL-c levels: LDL <90 mg/dl (group 1), LDL 90-115 mg/dl (group 2) and LDL >115 mg/dl (group 3).


RESULTS
The Cox regression analysis revealed that group 3 patients had the best outcome (p = 0.01 vs. groups 2 and 3), with 58% of them surviving longer than 50 months compared to 34% in group 1. The same trend was seen in the group of patients suffering from ischemic cardiomyopathy and in patients who were treated by statins (p = 0.04).


CONCLUSIONS
Low LDL-c levels are associated with a reduced survival in elderly patients with clinically controlled moderate and severe HF.
The Department of Internal Medicine 'C', Tel Aviv Sourasky Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Gideon
G
Charach
Alexander
A
Rabinovich
Argov
A
Ori
Dov
D
Weksler
David
D
Sheps
Lior
L
Charach
Moshe
M
Weintraub
Jacob
J
George
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000378:metabolism; D002316:Cardiotonic Agents / Q000627:therapeutic use; D008078:Cholesterol, LDL / Q000172:deficiency*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000188:drug therapy / Q000401:mortality*; D006801:Humans; D008297:Male; D011379:Prognosis; D015996:Survival Rate
D015415:Biomarkers; D002316:Cardiotonic Agents; D008078:Cholesterol, LDL