HDL-apoA-II Is Strongly Associated with 1-Year Mortality in Acute Heart Failure Patients

Abstract

The prognostic value of the subset of high-density lipoprotein (HDL) particles containing apolipoprotein (apo)A-II (HDL-apoA-II) in acute heart failure (AHF) remains unexplored. In this study, baseline serum levels of HDL-apoA-II (total and subfractions 1–4) were measured in 315 AHF patients using NMR spectroscopy. The mean patient age was 74.2 ± 10.5 years, 136 (43.2%) were female, 288 (91.4%) had a history of cardiomyopathy, 298 (94.6%) presented as New York Heart Association class 4, and 118 (37.5%) patients died within 1 year after hospitalization for AHF. Multivariable Cox regression analyses, adjusted for age and sex as well as other clinical and laboratory parameters associated with 1-year mortality in the univariable analyses, revealed a significant inverse association of HDL-apoA-II (hazard ratio (HR) 0.67 per 1 standard deviation (1 SD) increase, 95% confidence interval (CI) 0.47–0.94, p = 0.020), HDL2-apoA-II (HR 0.72 per 1 SD increase, 95% CI 0.54–0.95, p = 0.019), and HDL3-apoA-II (HR 0.59 per 1 SD increase, 95% CI 0.43–0.80, p < 0.001) with 1-year mortality. We conclude that low baseline HDL-apoA-II, HDL2-apoA-II, and HDL3-apoA-II serum levels are associated with increased 1-year mortality in AHF patients and may thus be of prognostic value in AHF.

Cholesterol Content of Very-Low-Density Lipoproteins Is Associated with 1-Year Mortality in Acute Heart Failure Patients

“…Baseline clinical characteristics, medication, and laboratory parameters of the whole cohort were described in our previous report [ 23 ] and are shown in Table 1 and Table S1 as a comparison between the patients who were alive and those who died within 1 year after hospitalization for AHF. The serum samples of 315 hospitalized patients with AHF that completed the 1 year follow-up were used for the present analyses.…”

“…Previously, we and others identified the prognostic capacity of small HDL-particles for AHF and CHF mortality [ 26 , 27 ]. More recently, we reported on the robust prognostic value of high-density lipoprotein apolipoprotein A-II (HDL-apoA-II) in AHF patients [ 23 ]. In the present study, we demonstrate for the first time the association of low cholesterol content of circulating VLDL (VLDL-C/VLDL-apoB) with 1 year mortality in AHF patients.…”

“…Study design, inclusion and exclusion criteria, and patient characteristics for the AHF cohort were described in our previous study [ 23 ] and are shown in Scheme S1 . The AHF study was a prospective, observational study including consecutive patients who were hospitalized due to AHF.…”

“…The collection of the blood samples and the standard laboratory methods were described in our previous report [ 23 ].…”

APOA2: New Target for Molecular Hydrogen Therapy in Sepsis-Related Lung Injury Based on Proteomic and Genomic Analysis

“…Our study indicated the causal relationships between Apoa2 and heart-related outcomes in sepsis. Some clinical studies also found that an increase in blood plasma HDL-Apoa-II would decrease the mortality caused by heart failure through measuring protein concentration using NMR spectroscopy [45].…”