ESC Heart Failure (Jun 2024)

Low‐density lipoprotein cholesterol, erythrocyte, and platelet in heart failure with preserved ejection fraction

  • Masamichi Yano,
  • Masami Nishino,
  • Shodai Kawanami,
  • Kohei Ukita,
  • Akito Kawamura,
  • Koji Yasumoto,
  • Masaki Tsuda,
  • Naotaka Okamoto,
  • Yasuharu Matsunaga‐Lee,
  • Yasuyuki Egami,
  • Takahisa Yamada,
  • Yoshio Yasumura,
  • Masahiro Seo,
  • Takaharu Hayashi,
  • Akito Nakagawa,
  • Yusuke Nakagawa,
  • Shunsuke Tamaki,
  • Yohei Sotomi,
  • Daisaku Nakatani,
  • Shungo Hikoso,
  • Yasushi Sakata,
  • the Osaka CardioVascular Conference (OCVC)‐Heart Failure Investigators

DOI
https://doi.org/10.1002/ehf2.14734
Journal volume & issue
Vol. 11, no. 3
pp. 1758 – 1766

Abstract

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Abstract Aims Low‐density lipoprotein cholesterol (LDL‐C), anaemia and low platelets have been associated with worse clinical outcomes in heart failure patients. We investigated the relationship between the combination of these three components and clinical outcome in patients with heart failure with preserved ejection fraction (HFpEF). Methods and results We examined the data of 1021 patients with HFpEF hospitalized with acute decompensated heart failure (HF) from the PURSUIT‐HFpEF registry, a prospective, multicenter observational study. The enrolled patients were classified into four groups by an LEP (LDL‐C, Erythrocyte, and Platelet) score of 0 to 3 points, with 1 point each for LDL‐C, erythrocyte and platelet values less than the cut‐off values as calculated by receiver operating characteristic curve analysis. The endpoint, a composite of all‐cause death and HF readmission, was evaluated among the four groups. Median follow‐up duration was 579 [300, 978] days. Risk of the composite endpoint significantly differed among the four groups (P < 0.001). Kaplan–Meier analysis showed that the groups with an LEP score of 2 had higher risk of the composite endpoint than those with an LEP score of 0 or 1 (P < 0.001, and P = 0.013, respectively), while those with an LEP score of 3 had higher risk than those with an LEP score of 0, 1 or 2 (P < 0.001, P < 0.001 and P = 0.020, respectively). Cox proportional hazards analysis showed that an LEP score of 3 was significantly associated with the composite endpoint (P = 0.030). Kaplan–Meier analysis showed that risk of the composite of all‐cause death and HF readmission was significantly higher in low LDL values (less than the cut‐off values as calculated by receiver operating characteristic curve analysis) patients with statin use than in those without statin use (log rank P = 0.002). Conclusions LEP score, which comprehensively reflects extra‐cardiac co‐morbidities, is significantly associated with clinical outcomes in HFpEF patients.

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