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Higher Total Cholesterol May Be Better in Heart Failure

September 1, 2006 - Total cholesterol around 200 mg/dL
is linked to higher survival in CHFers than levels below
140 mg/dL. Seventy percent of CHFers have inflammation,
which is linked to lower total cholesterol.
	Researchers evaluated TC (total cholesterol)
levels and survival in 1,646 CHFers selected from the
Intermountain Collaborative Study Registry, a 10-year
database covering 1993 to 2003.
	TC levels were divided into 4 ranges called 
quartiles:

1) quartile one being TC levels 141.3 mg/dL or less.

2) quartile 2 being TC levels of 141.4 to 167.9 mg/dL.

3) quartile 3 being TC levels between 168 to 201 mg/dL.

4) quartile 4 being TC levels above 201 mg/dL.

Average CHFer age was 65 years, with 65% men; 65%
had coronary artery disease. Average EF was 40% or less.
Average follow-up was 2-1/2 years (maximum follow-up
was 10 years). Fifty three percent of patients were taking
statin cholesterol lowering drugs but such use was equal
across all 4 quartiles.
	Quartile 3 patients were 34% less likely to die
than quartile one patients. Quartlile 2 patients were more
likely to die than quartile 3 patients but the difference was
not great.
	Mortality risk for quartile 1 and quartile 4 was
similar so cholesterol significantly over 200 is as bad as too-
low cholesterol.

Jon's Note: There is apparently a definite TC range CHFers
should try to hit - between 170 and 210. (end note)

Quartile 3 CHFers had the lowest average C-reactive protein
levels, meaning the lowest levels of inflammation in the 4
groups. The highest average C-reactive protein levels were
found in quartile one CHFers.
	CHFers using statins in quartile one had even
greater risk of death versus quartile one CHFers on statins.

Source:   Reuters Health.
Title:      Relation of serum total cholesterol, C-reactive protein
              levels, and statin therapy to survival in heart failure.
Authors: May HT, Muhlestein JB, Carlquist JF, Horne BD,
               Bair TL, Campbell BA, Kfoury AG, Lyon JL, Kim H,
               Renlund DG.
Source:   Am J Cardiol. 2006 Sep 1;98(5):653-8.
PMID:   16923455.