Association of outcome with non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio in hospitalized patients with congestive heart failure: a retrospective analysis.

Abstract

Objective: To investigate the association between the Non-HDL cholesterol to HDL cholesterol ratio (NHHR) and all-cause mortality in patients with congestive heart failure (CHF) and to determine whether NHHR levels influence the prognosis of CHF patients.

Methods: The study participants were stratified based on the quartiles of NHHR. Kaplan-Meier (KM) curves, multivariate Cox regression analysis, and restricted cubic spline (RCS) analysis were employed to determine whether the prognosis of CHF patients varied according to NHHR levels.

Results: Our study included 2156 patients, of whom 274 (12.7%) died during hospitalization, 337 (15.6%) within 28 days, 480 (22.3%) within 90 days, and 665 (30.8%) within one year. Restricted cubic spline (RCS) analysis revealed a distinct U-shaped association between NHHR levels and mortality in CHF patients, characterized by an initial rapid decline followed by a gradual increase in mortality risk. Notably, patients in the lowest NHHR quartile (Q1) demonstrated significantly elevated 28-day, 90-day, and 1-year mortality rates (all P < 0.01, as confirmed by the Log-rank test) compared to the lower three quartiles, as confirmed by log-rank tests. Following the adjustment for confounding variables, multivariate Cox regression analysis established a substantial correlation between NHHR and all-cause mortality in CHF patients.

Conclusion: A virtually U-shaped link exists between NHHR and all-cause mortality in CHF patients, and further study is needed to corroborate this finding.