In critically ill patients with congestive heart failure, the non-HDL to HDL cholesterol ratio exhibited a U-shaped association with mortality, where the second quartile (1.80-2.35) reduced 1-year mortality risk by 41% compared to the lowest quartile (HR 0.59).
Cohort (n=2,156)
No
Is the non-HDL cholesterol to HDL cholesterol ratio (NHHR) associated with all-cause mortality in hospitalized patients with congestive heart failure?
A U-shaped relationship exists between the non-HDL to HDL cholesterol ratio and all-cause mortality in hospitalized heart failure patients, suggesting both very low and high ratios are associated with worse prognosis.
Effect estimate: HR 0.59 (95% CI 0.44-0.80)
p-value: p=0.001
OBJECTIVE: To investigate the association between the Non-HDL cholesterol to HDL cholesterol ratio (NHHR) and all-cause mortality in patients with congestive heart failure (CHF) and to determine whether NHHR levels influence the prognosis of CHF patients. METHODS: The study participants were stratified based on the quartiles of NHHR. Kaplan-Meier (KM) curves, multivariate Cox regression analysis, and restricted cubic spline (RCS) analysis were employed to determine whether the prognosis of CHF patients varied according to NHHR levels. RESULTS: Our study included 2156 patients, of whom 274 (12.7%) died during hospitalization, 337 (15.6%) within 28 days, 480 (22.3%) within 90 days, and 665 (30.8%) within one year. Restricted cubic spline (RCS) analysis revealed a distinct U-shaped association between NHHR levels and mortality in CHF patients, characterized by an initial rapid decline followed by a gradual increase in mortality risk. Notably, patients in the lowest NHHR quartile (Q1) demonstrated significantly elevated 28-day, 90-day, and 1-year mortality rates (all P < 0.01, as confirmed by the Log-rank test) compared to the lower three quartiles, as confirmed by log-rank tests. Following the adjustment for confounding variables, multivariate Cox regression analysis established a substantial correlation between NHHR and all-cause mortality in CHF patients. CONCLUSION: A virtually U-shaped link exists between NHHR and all-cause mortality in CHF patients, and further study is needed to corroborate this finding.
Yu et al. (Fri,) conducted a cohort in Congestive heart failure (CHF) (n=2,156). Non-HDL cholesterol to HDL cholesterol ratio (NHHR) vs. Lowest NHHR quartile (Q1, <1.80) was evaluated on 1-year all-cause mortality (Q2 vs Q1) (HR 0.59, 95% CI 0.44-0.80, p=0.001). In critically ill patients with congestive heart failure, the non-HDL to HDL cholesterol ratio exhibited a U-shaped association with mortality, where the second quartile (1.80-2.35) reduced 1-year mortality risk by 41% compared to the lowest quartile (HR 0.59).