Sayed Ahmed, Afify Hesham, Munir Malak, ElGarhy Ibrahim, Shazly Omar, ElRefaei Mohamed, Ahmed Saeed, Amin Ahmed Mazen, Amine Omar Chikh, Elgendy Islam Y
Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Division of Cardiovascular Medicine, University of Louisville School of Medicine, Louisville, Kentucky, USA.
ESC Heart Fail. 2025 Aug;12(4):2691-2701. doi: 10.1002/ehf2.15315. Epub 2025 May 24.
We sought to evaluate the prognostic value of different lipid parameters in patients with heart failure (HF).
Electronic databases including MEDLINE, Embase, CENTRAL, and Web of Science were searched to identify studies that reported the association of any of the four lipid parameters [total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglycerides] with mortality among patients with HF. A random-effects model was used to estimate the association per 10 mg/dL increment. The QUIPS tool was used to assess the risk of bias. Fifty-two studies enrolling 93 286 patients were included. On univariable analysis, higher levels of the four lipid parameters were associated with lower mortality: TC [hazard ratio/odds ratio (HR/OR): 0.94; 95% confidence interval (CI): 0.93 to 0.96], HDL-C (HR/OR: 0.89; 95% CI: 0.80 to 0.99), LDL-C (HR/OR: 0.93; 95% CI: 0.90 to 0.97) and triglycerides (HR/OR: 0.95; 95% CI: 0.92 to 0.99). On multivariable analysis, lower levels of TC (HR/OR: 0.95; 95% CI: 0.93 to 0.97) and LDL-C (HR/OR: 0.94; 95% CI: 0.89 to 0.99) were associated with lower mortality.
Higher levels of lipids parameters were associated with lower mortality in patients with HF. Lipid parameters may improve prognostication in predictive models for patients with HF. Because of the observational nature of included studies, no claims about the causal effect of changing lipid parameters can be made.
我们试图评估不同血脂参数对心力衰竭（HF）患者的预后价值。
检索包括MEDLINE、Embase、CENTRAL和科学网在内的电子数据库，以确定报告四种血脂参数[总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）和甘油三酯]中任何一种与HF患者死亡率之间关联的研究。采用随机效应模型估计每增加10mg/dL的关联。使用QUIPS工具评估偏倚风险。纳入了52项研究，共93286例患者。单变量分析显示，四种血脂参数水平较高与较低的死亡率相关：TC[风险比/优势比（HR/OR）：0.94；95%置信区间（CI）：0.93至0.96]、HDL-C（HR/OR：0.89；95%CI：0.80至0.99）、LDL-C（HR/OR：0.93；95%CI：0.90至0.97）和甘油三酯（HR/OR：0.95；95%CI：0.92至0.99）。多变量分析显示，较低水平的TC（HR/OR：0.95；95%CI：0.93至0.97）和LDL-C（HR/OR：0.94；95%CI：0.89至0.99）与较低的死亡率相关。
较高水平的血脂参数与HF患者较低的死亡率相关。血脂参数可能改善HF患者预测模型中的预后评估。由于纳入研究的观察性性质，无法对改变血脂参数的因果效应做出断言。
