Journal Article

Relationship between the HDL-C/CRP ratio and all-cause mortality in patients with chronic heart failure: a retrospective analysis from Yunnan Province, China

Liuzhuang, Xiongyi, Gu, Wenyi, Shi, Tao, Xu, Chenggong, Yang, Yunhong, Chen, Lixing, Yang, Sirui

2025

Overview

ObjectiveTo clarify whether the high-density lipoprotein cholesterol/C reactive protein (HDL-C/CRP) ratio can be used as a new prognosticator of all-cause mortality in patients with chronic heart failure (CHF) (New York Heart Association (NYHA) cardiac class III/IV).DesignRetrospective study.BackgroundSeveral papers have revealed that HDL-C and CRP can act as anti-inflammatory and pro-inflammatory factors, respectively, to affect disease progression in patients with heart failure, and the balance of the two has been shown to affect the prognosis of patients with heart failure with preserved ejection fraction (HFpEF), but none of the above studies involved patients with the more severe forms of heart failure with mildly reduced ejection fraction and heart failure with reduced ejection fraction; therefore, the present study is to extend the balance of HDL-C and CRP to the whole range of types of patients CHF to further confirm its importance.SettingThis study is from a single centre in Yunnan Province, China.ParticipantsAfter excluding ineligible patients, we finally included 1192 patients with CHF from January 2017 to October 2021.Primary and secondary measuresThe primary outcome was all-cause mortality in patients with CHF between January 2017 and October 2021. No secondary outcome measures were performed.ResultsAll patients were divided into four groups according to the quartiles of the HDL-C/CRP ratio. Using the Kaplan-Meier analysis, the risk of all-cause mortality was always the highest for Q1 (HDL-C/CRP<0.395) and the lowest for group Q4 (HDL-C/CRP≥3.4163). Cox univariate and multivariate regression analyses showed that HDL-C/CRP was consistently an independent risk factor for death from CHF. Based on the receiver operating characteristic curve, the area under the curve for HDL-C/CRP was 0.7254 (p<0.001), with a sensitivity of 65.5% and a specificity of 69.6%.ConclusionsThe HDL-C/CRP ratio is an independent prognostic indicator of all-cause mortality in patients with CHF in NYHA cardiac function class III/IV, which has good specificity and sensitivity. Patients with lower levels of the HDL-C/CRP ratio are at a greater risk of death than patients with higher levels of the HDL-C/CRP ratio.

• Publisher: British Medical Journal Publishing Group,BMJ Publishing Group LTD,BMJ Publishing Group
• Subject: Aged / Biomarkers - blood / Blood / C-Reactive Protein - analysis / C-Reactive Protein - metabolism / Cardiovascular Disease / Cardiovascular Medicine / Cause of Death / China - epidemiology / Cholesterol / Cholesterol, HDL - blood / Chronic Disease / Ejection fraction / Female / Heart failure / Heart Failure - blood / Heart Failure - mortality / High density lipoprotein / Humans / Hypertension / Inflammation / Male / Medical prognosis / Middle Aged / Missing data / Mortality / Neutrophils / Original Research / Prognosis / Retrospective Studies / Statistical analysis / Statistical significance / Stroke Volume