Zampino Rosa, Patauner Fabian, Karruli Arta, Iossa Domenico, Ursi Maria Paola, Bertolino Lorenzo, Peluso Anna Maria, D'Amico Fabiana, Cavezza Giusi, Durante-Mangoni Emanuele
Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia, 2, 80138 Napoli, Italy.
Unit of Infectious & Transplant Medicine, AORN Ospedali dei Colli-Ospedale Monaldi, Piazzale Ettore Ruggieri, 80131 Napoli, Italy.
J Clin Med. 2022 Feb 12;11(4):957. doi: 10.3390/jcm11040957.
(1) Background: Simple parameters to be used as early predictors of prognosis in infective endocarditis (IE) are lacking. The aim of this study was to evaluate the prognostic role of high-density-lipoprotein cholesterol (HDL-C) and also of total-cholesterol (TC), low-density-lipoprotein cholesterol (LDL-C), and triglycerides, in relation to clinical features and mortality, in IE. (2) Methods: Retrospective analysis of observational data from 127 consecutive patients with a definite diagnosis of IE between 2016 and 2019. Clinical, laboratory and echocardiography data, mortality, and co-morbidities were analyzed in relation to HDL-C and lipid profile. (3) Results: Lower HDL-C levels ( = 0.035) were independently associated with in-hospital mortality. HDL-C levels were also significantly lower in IE patients with embolic events ( = 0.036). Based on ROC curve analysis, a cut-off value was identified for HDL-C equal to 24.5 mg/dL for in-hospital mortality. HDL-C values below this cut-off were associated with higher triglyceride counts ( = 0.008), higher prevalence of etiology ( = 0.046) and a higher in-hospital mortality rate ( = 0.004). Kaplan-Meier survival analysis showed higher 90-day mortality in patients with HDL-C ≤ 24.5 mg/dL ( = 0.001). (4) Conclusions: Low HDL-C levels could be used as an easy and low-cost marker of severity in IE, particularly to predict complications, in-hospital and 90-day mortality.
(1) 背景：目前缺乏可作为感染性心内膜炎（IE）预后早期预测指标的简单参数。本研究旨在评估高密度脂蛋白胆固醇（HDL-C）以及总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）和甘油三酯与IE临床特征及死亡率之间的预后关系。(2) 方法：对2016年至2019年间连续确诊的127例IE患者的观察数据进行回顾性分析。分析了与HDL-C及血脂谱相关的临床、实验室和超声心动图数据、死亡率及合并症。(3) 结果：较低的HDL-C水平（=0.035）与住院死亡率独立相关。发生栓塞事件的IE患者的HDL-C水平也显著较低（=0.036）。基于ROC曲线分析，确定住院死亡率的HDL-C临界值为24.5mg/dL。低于该临界值的HDL-C值与更高的甘油三酯计数（=0.008）、更高的病因患病率（=0.046）及更高的住院死亡率（=0.004）相关。Kaplan-Meier生存分析显示，HDL-C≤24.5mg/dL的患者90天死亡率更高（=0.001）。(4) 结论：低HDL-C水平可作为IE严重程度的一种简便且低成本的标志物，尤其可用于预测并发症、住院及90天死亡率。
