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

• Main Authors: Albert Teis, G. Cediel, N. Amigó, J. Julve, J. Aranyó, J. Andrés-Cordón, C. Puig-Jové, E. Castelblanco, F. Gual-Capllonch, E. Ferrer-Sistach, N. Vallejo, G. Juncà, J. López-Ayerbe, M. De Antonio, M. Domingo, E. Santiago-Vacas, P. Codina, D. Mauricio, J. Lupón, Nuria Alonso, A. Bayes-Genis
• Format: Article
• Language: English
• Published: Nature Publishing Group 2021-02-01
• Series: Scientific Reports
• Online Access: https://doi.org/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.