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The relationship between cholesterol and survival in patients with chronic heart failure

Open access
Rauchhaus, Mathias, Clark, Andrew L, Doehner, Wolfram, Davos, Constantinos, Bolger, Aidan, Sharma, Rakesh, Coats, Andrew J.S, Anker, Stefan D·2003·Journal of the American College of Cardiology

Abstract

OBJECTIVES We sought to describe the relationship between cholesterol and survival in patients with chronic heart failure (CHF). BACKGROUND Increasing lipoprotein levels are a cardiovascular risk factor. In patients with CHF, the prognostic value of endogenous lipoproteins is not fully clarified. METHODS A group of 114 patients with CHF recruited to a metabolic study was followed for a minimum of 12 months (derivation study). The results were applied to a second group of 303 unselected patients with CHF (validation study). The relationship between endogenous lipoproteins and survival was explored. RESULTS In the derivation study, survival at 12 months was 78% (95% confidence interval [CI] 70% to 86%) and 56% (95% CI 51% to 62%) at 36 months. Increasing total serum cholesterol was a predictor of survival (hazard ratio 0.64, 95% CI 0.48 to 0.86), independent of the etiology of CHF, age, left ventricular ejection fraction, and exercise capacity. Receiver-operating characteristic curves demonstrated a best cut-off value of </=5.2 mmol/l (200.8 mg/dl) as being the best predictor of mortality at 12 months (sensitivity 80.0%, specificity 62.9%). In the validation population, one-year survival was 88% (95% CI 84 to 91%) and three-year survival was 68% (95% CI 63 to 73%). The chance of survival increased 25% for each mmol/l increment in total cholesterol. Survival rates above and below the cut-off value for cholesterol in patients with ischemic heart disease (n = 181) were 92% (95% CI 89 to 94) versus 75% (95% CI 64 to 85%) at one year and 72% (95% CI 67 to 76%) versus 50% (95% CI 43 to 56%) at three years. CONCLUSIONS In patients with CHF, lower serum total cholesterol is independently associated with a worse prognosis.

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Metadata

Authors
Rauchhaus, M., Clark, A. L., Doehner, W., Davos, C., Bolger, A., Sharma, R., Coats, A. J. S., & Anker, S. D.
Venue
Journal of the American College of Cardiology
Publisher
Elsevier BV
Published
2003-12
Volume
42
Issue
11
Pages
1933-1940
ISSN
0735-1097 (ISSN-L)
OpenAlex
W2049348368
Cited by
444
References
37
FWCI
16.13
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: The relationship between cholesterol and survival in patients with chronic heart failure. https://app.cochat.ai/papers/10.1016/j.jacc.2003.07.016
The paper
Rauchhaus, M., Clark, A. L., Doehner, W., Davos, C., Bolger, A., Sharma, R., Coats, A. J. S., & Anker, S. D. (2003). The relationship between cholesterol and survival in patients with chronic heart failure. Journal of the American College of Cardiology. https://doi.org/10.1016/j.jacc.2003.07.016

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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