Key result
HDL-C/CRP ratio independently predicts all-cause mortality in chronic heart failure with ~0.73 AUC.
Why the study?
The balance of HDL-C and CRP affects prognosis in HFpEF, but studies had not evaluated this across the full spectrum of chronic heart failure types.
Does the HDL-C/CRP ratio predict all-cause mortality in patients with chronic heart failure (NYHA class III/IV)?
Cohort (n=1,192)
No
Does the HDL-C/CRP ratio predict all-cause mortality in patients with chronic heart failure (NYHA class III/IV)?
Effect estimate: AUC 0.7254
p-value: p=<0.001
A lower HDL-C/CRP ratio is an independent predictor of increased all-cause mortality in patients with NYHA class III/IV chronic heart failure.
Should not change risk stratification in advanced HF; hypothesis-generating and requires prospective validation.
Objective To clarify whether the high-density lipoprotein cholesterol/C reactive protein (HDL-C/CRP) ratio can be used as a new prognosticator of all-cause mortality in patients with chronic heart failure (CHF) (New York Heart Association (NYHA) cardiac class III/IV). Design Retrospective study. Background Several papers have revealed that HDL-C and CRP can act as anti-inflammatory and pro-inflammatory factors, respectively, to affect disease progression in patients with heart failure, and the balance of the two has been shown to affect the prognosis of patients with heart failure with preserved ejection fraction (HFpEF), but none of the above studies involved patients with the more severe forms of heart failure with mildly reduced ejection fraction and heart failure with reduced ejection fraction; therefore, the present study is to extend the balance of HDL-C and CRP to the whole range of types of patients CHF to further confirm its importance. Setting This study is from a single centre in Yunnan Province, China. Participants After excluding ineligible patients, we finally included 1192 patients with CHF from January 2017 to October 2021. Primary and secondary measures The primary outcome was all-cause mortality in patients with CHF between January 2017 and October 2021. No secondary outcome measures were performed. Results All patients were divided into four groups according to the quartiles of the HDL-C/CRP ratio. Using the Kaplan-Meier analysis, the risk of all-cause mortality was always the highest for Q1 (HDL-C/CRP<0.395) and the lowest for group Q4 (HDL-C/CRP≥3.4163). Cox univariate and multivariate regression analyses showed that HDL-C/CRP was consistently an independent risk factor for death from CHF. Based on the receiver operating characteristic curve, the area under the curve for HDL-C/CRP was 0.7254 (p<0.001), with a sensitivity of 65.5% and a specificity of 69.6%. Conclusions The HDL-C/CRP ratio is an independent prognostic indicator of all-cause mortality in patients with CHF in NYHA cardiac function class III/IV, which has good specificity and sensitivity. Patients with lower levels of the HDL-C/CRP ratio are at a greater risk of death than patients with higher levels of the HDL-C/CRP ratio.
No takes yet. Share an insight, caveat, or question.
Liuzhuang et al. (2025) conducted a cohort in Chronic heart failure (NYHA class III/IV) (n=1,192). HDL-C/CRP ratio vs. Higher vs lower HDL-C/CRP ratio quartiles was evaluated on All-cause mortality (AUC 0.7254, p=<0.001). The HDL-C/CRP ratio was an independent prognostic indicator of all-cause mortality in patients with chronic heart failure, with an area under the curve of 0.7254 (p<0.001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: