Cholesterol--a marker of nutritional status in mild to moderate heart failure.

Objective: To assess the association between serum cholesterol and nutritional status in patients with stable mild to moderate chronic heart failure (CHF).

Background: Hypercholesterolemia is a well-established risk factor for mortality and morbidity in coronary heart disease. In an apparent paradox, lower serum cholesterol has been associated with worse prognosis in CHF. Pre-albumin is the preferred marker for undernutrition in chronic diseases.

Methods: We evaluated 92 CHF patients, mean age 68 years, mean body mass index 27 kg/m(2); 44 with ischemic etiology; 41 in New York Heart Association class I. Patients were included after a period of at least 2 months of clinical stability. Spearman's correlation coefficient between serum cholesterol and pre-albumin, both in the whole sample and stratifying by the use of statins was calculated.

Results: Median (interquartile range) cholesterol level was 174 (142-214) mg/dl and median pre-albumin level was 31 (25-37) mg/dl. Overall, there was a moderately strong and statistically significant positive correlation between pre-albumin and serum cholesterol (Rho=0.57, p<0.001). Among the 20 patients not on statin the correlation coefficient was 0.84 (p<0.001), while among the 72 patients under a statin the correlation was 0.49 (p<0.001).

Conclusion: Our results suggest that in stable mild to moderate CHF patients, cholesterol levels are closely related with nutritional status irrespective of therapy with a statin.