Low-density lipoprotein cholesterol and survival in pulmonary arterial hypertension

Grzegorz Kopeć, Marcin Waligóra, Anna Tyrka, Kamil Jonas, Michael J Pencina, Tomasz Zdrojewski, Deddo Moertl, Jakub Stokwiszewski, Paweł Zagożdżon, Piotr Podolec

Research output: Journal article (peer-reviewed)Journal article

23 Citations (Scopus)


Low-density lipoprotein cholesterol(LDL-C) is a well established metabolic marker of cardiovascular risk, however, its role in pulmonary arterial hypertension (PAH) has not been determined. Therefore we assessed whether LDL-C levels are altered in PAH patients, if they are associated with survival in this group and whether pulmonary hypertension (PH) reversal can influence LDL-C levels. Consecutive 46 PAH males and 94 females were age matched with a representative sample of 1168 males and 1245 females, respectively. Cox regression models were used to assess the association between LDL-C and mortality. The effect of PH reversal on LDL-C levels was assessed in 34 patients with chronic thromboembolic pulmonary hypertension (CTEPH) undergoing invasive treatment. LDL-C was lower in both PAH (2.6 ± 0.8 mmol/l) and CTEPH (2.7 ± 0.7 mmol/l) patients when compared to controls (3.2 ± 1.1 mmol/l, p < 0.001). In PAH patients lower LDL-C significantly predicted death (HR:0.44/1 mmol/l, 95%CI:0.26-0.74, p = 0.002) after a median follow-up time of 33(21-36) months. In the CTEPH group, LDL-C increased (from 2.6[2.1-3.2] to 4.0[2.8-4.9]mmol/l, p = 0.01) in patients with PH reversal but remained unchanged in other patients (2.4[2.2-2.7] vs 2.3[2.1-2.5]mmol/l, p = 0.51). We concluded that LDL-C level is low in patients with PAH and is associated with an increased risk of death. Reversal of PH increases LDL-C levels.

Original languageEnglish
Article number41650
Pages (from-to)41650
JournalScientific Reports
Publication statusPublished - 15 Feb 2017


  • Adult
  • Age Factors
  • Biomarkers
  • Case-Control Studies
  • Cholesterol, LDL/blood
  • Female
  • Follow-Up Studies
  • Humans
  • Hypertension, Pulmonary/blood
  • Male
  • Middle Aged
  • Prognosis
  • Proportional Hazards Models
  • Risk Factors
  • Sex Factors


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