Cholesterol levels and in-hospital mortality in patients with acute decompensated heart failure

BACKGROUND: In chronic heart failure (HF), lower total cholesterol (TC) levels have been associated with increased mortality. However, the relationship between lipid levels and outcomes in acute HF has not been studied. This study investigates the relationship between cholesterol levels and in-hospital mortality in patients hospitalized with acute HF. METHODS: The Get With the Guidelines-Heart Failure registry prospectively collects data on patients hospitalized with HF. We analyzed data on 17,791 patients admitted between January 2005 and June 2007 at 236 participating hospitals who had TC levels recorded. Baseline patient characteristics, treatment regimens, and in-hospital mortality were examined by TC level (mg/dL) quartiles (Q) as follows: Q1 (TC or =180). RESULTS: Mean TC level was 150 +/- 47 mg/dL. Patients with lower TC were older and had higher prevalence of ischemic heart disease. Of the patients, 46% were on a lipid-lowering drug, including 58%, 50%, 43%, and 34% of patients in TC Q1 to Q4, respectively. In-hospital mortality in TC Q1 to Q4 was 3.3%, 2.5%, 2.0%, and 1.3%, respectively (P