Low-Density Lipoprotein Cholesterol thresholds in patients with heart failure of ischemic vs non-ischemic etiology

BACKGROUND Keeping lipid levels under control is key to preventing secondary cardiovascular events; however, few studies have detailed in depth the characteristics of patients with coronary artery disease according to low-density lipoprotein cholesterol (LDL-C) levels. OBJECTIVE To characterize patients with heart failure (HF) of ischemic or nonischemic etiology according to their LDL-C levels and considering the thresholds of <70 mg/dL and <100 mg/dL for LDL-C goals. METHODS We present the results from the third phase of the Colombian Registry of Heart Failure (RECOLFACA). Sociodemographic, clinical, and laboratory data were collected at baseline. For the LDL-C goal analysis, we conducted a logistic regression model. RESULTS We included 1124 patients, 554 with ischemic and 570 with nonischemic HF. The cohort included 379 women (33.7%) and 745 men (66.3%). There was a difference in the prescription of statins observed for both ischemic and nonischemic HF groups. Patients with ischemic HF had a 62% probability of being at the LDL-C <70 mg/dL goal (odds ratio OR = 1.62) and a 43% probability of being at the <100 mg/dL goal (OR = 1.43). Rosuvastatin was more used by patients with ischemic HF in the <70 mg/dL LDL-C goal group in comparison to those on the same goal group but with nonischemic HF (40.4% vs 19.6%, respectively). Similar results were reported for the <100 mg/dL LDL-C goal. CONCLUSION Our findings provide insights into distinct clinical profiles, treatment patterns, and LDL goal attainment in patients with ischemic and nonischemic HF, emphasizing the need for tailored management strategies based on HF etiology.