Low-density lipoprotein cholesterol and survival in pulmonary arterial hypertension.
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2017-02-15
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Abstract
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.
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Kopeć, Grzegorz, Marcin Waligóra, Anna Tyrka, Kamil Jonas, Michael J Pencina, Tomasz Zdrojewski, Deddo Moertl, Jakub Stokwiszewski, et al. (2017). Low-density lipoprotein cholesterol and survival in pulmonary arterial hypertension. Scientific reports, 7(1). p. 41650. 10.1038/srep41650 Retrieved from https://hdl.handle.net/10161/20620.
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Michael J Pencina
Michael J. Pencina, PhD
Chief Data Scientist, Duke Health
Vice Dean for Data Science
Director, Duke AI Health
Professor, Biostatistics & Bioinformatics
Duke University School of Medicine
Michael J. Pencina, PhD, is Duke Health's chief data scientist and serves as vice dean for data science, director of Duke AI Health, and professor of biostatistics and bioinformatics at the Duke University School of Medicine. His work bridges the fields of data science, health care, and AI, contributing to Duke’s national leadership in trustworthy health AI.
Dr. Pencina partners with key leaders to develop data science strategies for Duke Health that span and connect academic research and clinical care. As vice dean for data science, he develops and implements quantitative science strategies to support the School of Medicine’s missions in education and training, laboratory and clinical science, and data science.
He co-founded and co-leads the national Coalition for Health AI (CHAI), a multi-stakeholder effort whose mission is to increase trustworthiness of AI by developing guidelines to drive high-quality health care through the adoption of credible, fair, and transparent health AI systems. He also spearheaded the establishment and co-chairs Duke Health’s Algorithm-Based Clinical Decision Support (ABCDS) Oversight Committee and serves as co-director of Duke’s Collaborative to Advance Clinical Health Equity (CACHE).
Dr. Pencina is an internationally recognized authority in the evaluation of AI algorithms. Guideline groups rely on his work to advance best practices for the application of clinical decision support tools in health delivery. He interacts frequently with investigators from academic and industry institutions as well as government officials. Since 2014, he has been acknowledged annually by Thomson Reuters/Clarivate Analytics as one of the world’s "highly cited researchers" in clinical medicine and social sciences, with over 400 publications cited over 100,000 times. He serves as a deputy editor for statistics at JAMA-Cardiology.
Dr. Pencina joined the Duke University faculty in 2013, and served as director of biostatistics for the Duke Clinical Research Institute until 2018. Previously, he was an associate professor in the Department of Biostatistics at Boston University and the Framingham Heart Study, and director of statistical consulting at the Harvard Clinical Research Institute. He received his PhD in Mathematics and Statistics from Boston University in 2003 and holds master’s degrees from the University of Warsaw in actuarial mathematics and business culture.
Email: michael.pencina@duke.edu
Web Sites: medschool.duke.edu; aihealth.duke.edu; https://scholars.duke.edu/person/michael.pencina
Phone: 919.613.9066
Address: Duke University School of Medicine; 2424 Erwin Road, Suite 903; Durham, NC 27705
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