Impaired High‐Density Lipoprotein Function in Patients With Heart Failure
Background We recently showed that, in patients with heart failure, lower high‐density lipoprotein (HDL) cholesterol concentration was a strong predictor of death or hospitalization for heart failure. In a follow‐up study, we suggested that this association could be partly explained by HDL proteome...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-05-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.120.019123 |
| _version_ | 1818776481099153408 |
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| author | Johanna E. Emmens Congzhuo Jia Leong L. Ng Dirk J. van Veldhuisen Kenneth Dickstein Stefan D. Anker Chim C. Lang Gerasimos Filippatos John G. F. Cleland Marco Metra Adriaan A. Voors Rudolf A. de Boer Uwe J. F. Tietge |
| author_facet | Johanna E. Emmens Congzhuo Jia Leong L. Ng Dirk J. van Veldhuisen Kenneth Dickstein Stefan D. Anker Chim C. Lang Gerasimos Filippatos John G. F. Cleland Marco Metra Adriaan A. Voors Rudolf A. de Boer Uwe J. F. Tietge |
| author_sort | Johanna E. Emmens |
| collection | DOAJ |
| description | Background We recently showed that, in patients with heart failure, lower high‐density lipoprotein (HDL) cholesterol concentration was a strong predictor of death or hospitalization for heart failure. In a follow‐up study, we suggested that this association could be partly explained by HDL proteome composition. However, whether the emerging concept of HDL function contributes to the prognosis of patients with heart failure has not been addressed. Methods and Results We measured 3 key protective HDL function metrics, namely, cholesterol efflux, antioxidative capacity, and anti‐inflammatory capacity, at baseline and after 9 months in 446 randomly selected patients with heart failure from BIOSTAT‐CHF (A Systems Biology Study to Tailored Treatment in Chronic Heart Failure). Additionally, the relationship between HDL functionality and HDL proteome composition was determined in 86 patients with heart failure. From baseline to 9 months, HDL cholesterol concentrations were unchanged, but HDL cholesterol efflux and anti‐inflammatory capacity declined (both P<0.001). In contrast, antioxidative capacity increased (P<0.001). Higher HDL cholesterol efflux was associated with lower mortality after adjusting for BIOSTAT‐CHF risk models and log HDL cholesterol (hazard ratio, 0.81; 95% CI, 0.71–0.92; P=0.001). Other functionality measures were not associated with outcome. Several HDL proteins correlated with HDL functionality, mainly with cholesterol efflux. Apolipoprotein A1 emerged as the main protein associated with all 3 HDL functionality measures. Conclusions Better HDL cholesterol efflux at baseline was associated with lower mortality during follow‐up, independent of HDL cholesterol. HDL cholesterol efflux and anti‐inflammatory capacity declined during follow‐up in patients with heart failure. Measures of HDL function may provide clinical information in addition to HDL cholesterol concentration in patients with heart failure. |
| first_indexed | 2024-12-18T11:13:33Z |
| format | Article |
| id | doaj.art-5575ab784f3a4000875dbe6a6d4b97c9 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-18T11:13:33Z |
| publishDate | 2021-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-5575ab784f3a4000875dbe6a6d4b97c92022-12-21T21:09:57ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802021-05-0110910.1161/JAHA.120.019123Impaired High‐Density Lipoprotein Function in Patients With Heart FailureJohanna E. Emmens0Congzhuo Jia1Leong L. Ng2Dirk J. van Veldhuisen3Kenneth Dickstein4Stefan D. Anker5Chim C. Lang6Gerasimos Filippatos7John G. F. Cleland8Marco Metra9Adriaan A. Voors10Rudolf A. de Boer11Uwe J. F. Tietge12Department of Cardiology University of Groningen Groningen The NetherlandsDepartment of Pediatrics University of Groningen Groningen The NetherlandsDepartment of Cardiovascular Sciences Glenfield HospitalUniversity of Leicester Leicester UKDepartment of Cardiology University of Groningen Groningen The NetherlandsUniversity of Bergen Bergen NorwayDepartment of Cardiology (CVK) Berlin GermanySchool of Medicine Centre for Cardiovascular and Lung Biology Division of Molecular and Clinical Medicine University of Dundee Dundee UKNational and Kapodistrian University of AthensSchool of Medicine Athens GreeceNational Heart & Lung InstituteRoyal Brompton & Harefield HospitalsImperial College London UKInstitute of Cardiology Department of Medical and Surgical Specialties Radiological Sciences and Public Health University of Brescia Brescia ItalyDepartment of Cardiology University of Groningen Groningen The NetherlandsDepartment of Cardiology University of Groningen Groningen The NetherlandsDepartment of Pediatrics University of Groningen Groningen The NetherlandsBackground We recently showed that, in patients with heart failure, lower high‐density lipoprotein (HDL) cholesterol concentration was a strong predictor of death or hospitalization for heart failure. In a follow‐up study, we suggested that this association could be partly explained by HDL proteome composition. However, whether the emerging concept of HDL function contributes to the prognosis of patients with heart failure has not been addressed. Methods and Results We measured 3 key protective HDL function metrics, namely, cholesterol efflux, antioxidative capacity, and anti‐inflammatory capacity, at baseline and after 9 months in 446 randomly selected patients with heart failure from BIOSTAT‐CHF (A Systems Biology Study to Tailored Treatment in Chronic Heart Failure). Additionally, the relationship between HDL functionality and HDL proteome composition was determined in 86 patients with heart failure. From baseline to 9 months, HDL cholesterol concentrations were unchanged, but HDL cholesterol efflux and anti‐inflammatory capacity declined (both P<0.001). In contrast, antioxidative capacity increased (P<0.001). Higher HDL cholesterol efflux was associated with lower mortality after adjusting for BIOSTAT‐CHF risk models and log HDL cholesterol (hazard ratio, 0.81; 95% CI, 0.71–0.92; P=0.001). Other functionality measures were not associated with outcome. Several HDL proteins correlated with HDL functionality, mainly with cholesterol efflux. Apolipoprotein A1 emerged as the main protein associated with all 3 HDL functionality measures. Conclusions Better HDL cholesterol efflux at baseline was associated with lower mortality during follow‐up, independent of HDL cholesterol. HDL cholesterol efflux and anti‐inflammatory capacity declined during follow‐up in patients with heart failure. Measures of HDL function may provide clinical information in addition to HDL cholesterol concentration in patients with heart failure.https://www.ahajournals.org/doi/10.1161/JAHA.120.019123cholesterol effluxfunctionalityhigh‐density lipoproteinoutcomeproteome |
| spellingShingle | Johanna E. Emmens Congzhuo Jia Leong L. Ng Dirk J. van Veldhuisen Kenneth Dickstein Stefan D. Anker Chim C. Lang Gerasimos Filippatos John G. F. Cleland Marco Metra Adriaan A. Voors Rudolf A. de Boer Uwe J. F. Tietge Impaired High‐Density Lipoprotein Function in Patients With Heart Failure Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease cholesterol efflux functionality high‐density lipoprotein outcome proteome |
| title | Impaired High‐Density Lipoprotein Function in Patients With Heart Failure |
| title_full | Impaired High‐Density Lipoprotein Function in Patients With Heart Failure |
| title_fullStr | Impaired High‐Density Lipoprotein Function in Patients With Heart Failure |
| title_full_unstemmed | Impaired High‐Density Lipoprotein Function in Patients With Heart Failure |
| title_short | Impaired High‐Density Lipoprotein Function in Patients With Heart Failure |
| title_sort | impaired high density lipoprotein function in patients with heart failure |
| topic | cholesterol efflux functionality high‐density lipoprotein outcome proteome |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.120.019123 |
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