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- Title
A longitudinal 20 years of follow up showed a decrease in the survival of heart failure patients who maintained low LDL cholesterol levels.
- Authors
Charach, G; Argov, O; Nochomovitz, H; Rogowski, O; Charach, L; Grosskopf, I
- Abstract
Background: Treatment by statins is well established for primary and secondary prevention of cardiac events but may be hazardous for patients with heart failure (HF). Aim: We studied the long-term (20 years) association between baseline low-density lipoprotein cholesterol (LDL-c) levels and clinical outcome in patients with severe HF. Design: Patients were divided into those with plasma LDL-C levels 110 mg/dl (Group 1) or >110 mg/dl (Group 2). Methods: The mean follow-up of 305 study patients with advanced HF who had an average NYHA score of 2.7 was 11.3 years (range 15 months to 20 years). Mortality during follow-up was 43%. Results: Patients with the highest baseline LDL-c levels had significantly improved outcome, whereas those with the lowest LDL-c levels had the highest mortality. This paradoxical effect was prominent in patients<70 years old. The negative association of LDL-c levels and mortality was most conspicuous among the HF patients who were treated with statins. Discussion and Conclusion: Long-term follow-up findings showed that low LDL-c levels may predict a less favorable outcome in advanced HF, particularly in patients<70 years old and those taking statins. This negates the protocol of following an aggressive LDL-c-lowering strategy in younger patients with HF.
- Subjects
HEART failure treatment; TREATMENT effectiveness; HEART failure patients; LOW density lipoproteins; STATINS (Cardiovascular agents); CARDIOVASCULAR diseases risk factors; SURVIVAL analysis (Biometry); LONGITUDINAL method
- Publication
QJM: An International Journal of Medicine, 2018, Vol 111, Issue 5, p319
- ISSN
1460-2725
- Publication type
Article
- DOI
10.1093/qjmed/hcy043