Association of the sdLDL-C/lbLDL-C ratio with heart failure beyond conventional LDL-C levels: a cross-sectional study

Background Heart failure (HF) is one of the major cardiovascular diseases and the leading cause of death globally. Blood lipid profile is associated with HF early risk. Therefore, we aimed to explore the association between blood lipid profile and HF. Methods A total of 584 newly diagnosed HF patients and 611 non-HF controls were included. Clinical characteristics and routine lipid parameters were collected. LDL-C subfractions (LDLC-1 to LDLC-7) were quantified using the LDL subfractions kit. Multivariable logistic regression analysis was performed to identify independent correlates of HF. Results Among 584 HF patients and 611 controls, conventional LDL-C did not significantly differ between groups. However, HF patients had significantly higher sdLDL-C level, lower lbLDL-C level, and higher sdLDL-C/lbLDL-C ratio than controls. Multivariable logistic regression identified sdLDL-C/lbLDL-C ratio (OR = 2.199, 95%CI: 1.293–3.874, P < 0.001) as independent factor associated with HF. Conclusions Lipoprotein subfraction characteristics, particularly the sdLDL-C/lbLDL-C ratio, is significantly associated with HF status and cardiac function.