High-density lipoprotein cholesterol levels and prognosis in non-ischemic dilated cardiomyopathy.
C, G., M, Z., S, G., C, L., & J, Z. (2026). High-density lipoprotein cholesterol levels and prognosis in non-ischemic dilated cardiomyopathy.. Frontiers in endocrinology. https://doi.org/10.3389/fendo.2026.1843944
C G, M Z, S G, C L, J Z. High-density lipoprotein cholesterol levels and prognosis in non-ischemic dilated cardiomyopathy.. Frontiers in endocrinology. 2026; doi: 10.3389/fendo.2026.1843944
C G, M Z, S G, et al. High-density lipoprotein cholesterol levels and prognosis in non-ischemic dilated cardiomyopathy.[J]. Frontiers in endocrinology. 2026. DOI: 10.3389/fendo.2026.1843944.
@article{c2026,
author = {Gong C and Zhou M and Gong S and Liu C and Zhang J},
title = {High-density lipoprotein cholesterol levels and prognosis in non-ischemic dilated cardiomyopathy.},
journal = {Frontiers in endocrinology},
year = {2026},
doi = {10.3389/fendo.2026.1843944},
note = {PMID: 42434297},
}
TY - JOUR AU - Gong C AU - Zhou M AU - Gong S AU - Liu C AU - Zhang J TI - High-density lipoprotein cholesterol levels and prognosis in non-ischemic dilated cardiomyopathy. T2 - Frontiers in endocrinology PY - 2026 DO - 10.3389/fendo.2026.1843944 AN - PMID:42434297 ER -
BACKGROUND: Although low high-density lipoprotein cholesterol (HDL-C) is associated with poor outcomes in heart failure, its specific prognostic role in non-ischemic dilated cardiomyopathy (DCM) remains undefined. This study aimed to investigate the association between HDL-C levels and long-term clinical outcomes in patients with DCM. METHODS: We retrospectively enrolled 297 patients with DCM who underwent cardiac magnetic resonance between January 2017 and October 2024. The primary endpoint was a composite of all-cause mortality and heart transplantation; the secondary endpoint additionally included heart failure readmission. The associations between HDL-C and clinical outcomes were assessed using Kaplan-Meier analysis, Cox regression, restricted cubic spline (RCS), and sensitivity analyses. RESULTS: During a median follow-up of 35 months, 41 (13.8%) and 97 (32.7%) patients experienced the primary and secondary endpoints, respectively. Kaplan-Meier analysis demonstrated that patients with higher HDL-C had significantly better event-free survival for both the primary and secondary endpoints (log-rank P < 0.001 for both). In multivariable Cox regression models, lower HDL-C was consistently and independently associated with an increased risk of the primary (hazard ratio [HR] 0.19, 95% confidence interval [CI]: 0.05-0.68, P = 0.011) and secondary (HR 0.15, 95% CI: 0.07-0.34, P < 0.001) endpoints. After further adjustment for echocardiographically estimated pulmonary artery systolic pressure, the effect estimate for the association between HDL-C and clinical outcomes was attenuated (primary endpoint: HR 0.31, 95% CI: 0.08-1.11, P = 0.072; secondary endpoint: HR 0.19, 95% CI: 0.08-0.44, P < 0.001). RCS curves showed a linear relationship between HDL-C and both endpoints (P for nonlinearity > 0.05 for both). Sensitivity analyses confirmed the robustness of the results. CONCLUSIONS: Lower HDL-C levels were independently associated with adverse outcomes in patients with non-ischemic DCM, an association partly attenuated by adjusting for pulmonary hypertension markers. As a readily available prognostic biomarker, HDL-C may inform risk stratification in this population.