Association of High-Density Lipoprotein Parameters and Risk of Heart Failure: A Multicohort Analysis

Ambarish Pandey, Kershaw V. Patel, Matthew W. Segar, Michael D. Shapiro, Christie M. Ballantyne, Salim S. Virani, Vijay Nambi, Erin D. Michos, Michael J. Blaha, Khurram Nasir, Miguel Cainzos-Achirica, Colby R. Ayers, B. Daan Westenbrink, Jose L. Flores-Guerrero, Stephan J.L. Bakker, Margery A. Connelly, Robin P.F. Dullaart, Anand Rohatgi

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Background: High-density lipoprotein (HDL) is commonly characterized by its cholesterol concentration (HDL-C) and inverse association with atherosclerotic cardiovascular disease. Objectives: The authors sought to evaluate the association of HDL particle concentration (HDL-P), HDL particle size (HDL-size), HDL-C, and cholesterol content per particle (HDL-C/HDL-P) with risk of overall heart failure (HF) and subtypes. Methods: Participants from the Atherosclerosis Risk In Communities Study, Dallas Heart Study, Multi-Ethnic Study of Atherosclerosis, and Prevention of Renal and Vascular End-stage Disease studies without HF history were included. Associations of HDL-P, HDL-size, HDL-C, and HDL-C/HDL-P with risk of overall HF, HF with reduced and preserved ejection fraction were assessed using adjusted Cox models. Results: Among 16,925 participants (53.5% women; 21.8% Black), there were 612 incident HF events (3.6%) (HF with reduced ejection fraction, 309 [50.5%]; HF preserved ejection fraction, 303 [49.5%]) over median follow-up of 11.4 years. In adjusted models, higher HDL-P was significantly associated with lower HF risk (HR of highest vs lowest tertile of HDL-P: 0.76 [95% CI: 0.62-0.93]). Larger HDL-size was significantly associated with higher overall HF risk (HR of largest vs smallest tertile of HDL-size: 1.27 [95% CI: 1.03-1.58]). HF risk associated with HDL-P and HDL-size was similar for HF subtypes. In adjusted analyses, there was no significant association between HDL-C and HF risk. Higher HDL-C/HDL-P was significantly associated with higher overall HF risk (HR of highest vs lowest tertile of HDL-C/HDL-P: 1.29 [95% CI: 1.04-1.60]). Conclusions: Higher HDL-P was associated with a lower risk of HF. In contrast, larger HDL-size was associated with higher risk of HF and there was no significant association observed between HDL-C and HF risk after accounting for cardiovascular risk factors.

Original languageEnglish
JournalJACC: Heart Failure
DOIs
Publication statusAccepted/In press - 2024

Keywords

  • epidemiology
  • heart failure
  • high-density lipoprotein
  • multiethnic

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