High density lipoprotein cholesterol / C reactive protein ratio in heart failure with preserved ejection fraction

• Main Authors: Masamichi Yano, Masami Nishino, Kohei Ukita, Akito Kawamura, Hitoshi Nakamura, Yutaka Matsuhiro, Koji Yasumoto, Masaki Tsuda, Naotaka Okamoto, Akihiro Tanaka, Yasuharu Matsunaga‐Lee, Yasuyuki Egami, Ryu Shutta, Jun Tanouchi, Takahisa Yamada, Yoshio Yasumura, Shunsuke Tamaki, Takaharu Hayashi, Akito Nakagawa, Yusuke Nakagawa, Shinichiro Suna, Daisaku Nakatani, Shungo Hikoso, Yasushi Sakata, Osaka CardioVascular Conference (OCVC)‐Heart Failure Investigators
• Format: Article
• Language: English
• Published: Wiley 2021-08-01
• Series: ESC Heart Failure
• Subjects: Heart failure with preserved ejection fraction; Inflammation; High density lipoprotein cholesterol/C reactive protein ratio; Left ventricular diastolic function; Right ventricular systolic function
• Online Access: https://doi.org/10.1002/ehf2.13350

Abstract Aims The impacts of high density lipoprotein cholesterol (HDL‐C) as an anti‐inflammatory and C reactive protein (CRP) as inflammatory properties on the pathogenesis of heart failure were reported. At present, the clinical significance of the HDL‐C/CRP ratio in heart failure with preserved ejection fraction (HFpEF) patients remains unknown. Methods and results We examined the data on 796 consecutive HFpEF (left ventricular ejection fraction ≥50%) patients hospitalized due to acute decompensated heart failure from the PURSUIT‐HFpEF registry, a prospective, multicentre observational study. We calculated the HDL/CRP ratios and evaluated the relationship between the values and clinical outcomes, including degree of cardiac function. The mean follow‐up duration was 420 ± 346 days. All‐cause death occurred in 118 patients, of which 51 were cardiac deaths. HDL/CRP ≤ 4.05 was independently and significantly associated with all‐cause death (odds ratio = 1.84, 95% CI: 1.06–3.20, P = 0.023), and HDL/CRP ≤ 3.14 was associated with cardiac death by multivariate Cox proportional hazard analysis (odds ratio = 2.86, 95% CI: 1.36–6.01, P = 0.003). HDL‐C/CRP ratio significantly correlated with the product of the left atrial volume and left ventricular mass index as well as the tricuspid annular plane systolic excursion by multiple regression analysis (standardized beta‐coefficient = −0.085, P = 0.034 and standardized beta‐coefficient = 0.081, P = 0.044, respectively). Conclusions HDL‐C/CRP ratio was a useful marker for predicting all‐cause death and cardiac death and correlated with left ventricular diastolic function and right ventricular systolic function in HFpEF patients.