AUTHOR=Li Han-biao , Fu Bing-qi , Tan Tong , Li Xiao-hua , Wang Shou-hong , Wei Xue-biao , Wang Zhong-hua 

TITLE=Low-Density Lipoprotein Cholesterol and Mortality Risk in Elderly Patients Undergoing Valve Replacement Surgery: A Propensity Score Matching Analysis

JOURNAL=Frontiers in Nutrition

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2022.842734

DOI=10.3389/fnut.2022.842734

ISSN=2296-861X

ABSTRACT=<sec><title>Background</title><p>The prognostic value of low-density lipoprotein cholesterol (LDL-C) in elderly patients is controversial. This study aimed to elucidate the relationship between the preoperative LDL-C and adverse outcomes in elderly patients undergoing valve replacement surgery (VRS).</p></sec><sec><title>Methods</title><p>A total of 2,552 aged patients (age ≥ 60 years) undergoing VRS were retrospectively recruited and divided into two groups according to LDL-C level on admission: low LDL-C (&lt;70 mg/dL, <italic>n</italic> = 205) and high LDL-C groups (≥ 70 mg/dL, <italic>n</italic> = 2,347). The association between the preoperative LDL-C with in-hospital and one-year mortality was evaluated by propensity score matching analysis and multivariate analysis.</p></sec><sec><title>Results</title><p>The mean age was 65 ± 4 years and 1,263 (49.5%) were men. Patients in the low LDL-C group were significantly older (65.9 ± 4.6 vs. 64.9 ± 4.1, <italic>p</italic> = 0.002), with more male (65.4 vs. 48.1%, <italic>p</italic> &lt; 0.001), higher alanine transaminase (ALT) (21 vs. 19, <italic>p</italic> = 0.001), lower serum albumin (35.3 ± 4.6 vs. 37.1 ± 4.1, <italic>p</italic> &lt; 0.001), higher serum creatinine (92.2 ± 38.2 vs.84.6 ± 26.1, <italic>p</italic> = 0.006), lower lymphocyte count (1.7 ± 0.7 vs. 1.9 ± 0.6, <italic>p</italic> &lt; 0.001), lower hemoglobin (121.9 ± 22.3 vs. 130.2 ± 16.5, <italic>p</italic> &lt; 0.001), lower platelet count (171.3 ± 64.3 vs. 187.7 ± 58.7, <italic>p</italic> &lt; 0.001), lower prognostic nutrition index (44 ± 6.2 vs. 46.7 ± 5.8, <italic>p</italic> &lt; 0.001), and more severe tricuspid regurgitation (33.7 vs. 25.1%, <italic>p</italic> = 0.008). The rates of in-hospital death (11.2 vs. 3.7%, <italic>p</italic> &lt; 0.001) and major adverse clinical events (17.6 vs. 9.6%, <italic>p</italic> &lt; 0.001) were significantly higher in the low LDL-C group. The cumulative one-year death rate was significantly higher in the low LDL-C group (Log-Rank = 16.6, <italic>p</italic> &lt; 0.001). After matching analysis and multivariate analysis, no association between LDL-C level and adverse outcomes was detected (all <italic>p</italic> &gt; 0.05).</p></sec><sec><title>Conclusion</title><p>Our study did not support the negative relationship between LDL-C level and mortality risk in elderly patients undergoing VRS.</p></sec>