Abstract: Abstract Objective:To study the association between the lipid levels and prognosis in elder patients with chronic heart failure（CHF） who had coronary artery disease（CAD）. Methods:970 patients enrolled from the cardiology department of 2nd Hospital Tianjin Medical University who had clinical diagnoses of CHF with CAD from January 2005 to December 2007. Total cholesterol (TC), Triglycerides(TG), Low-density lipoprotein cholesterol (LDL-C) and High-density lipoprotein cholesterol (HDL-C) were divided into quartile. Patients were grouped with death (206 cases) and living (764 cases). According to statin-using，compared the mortality in various lipid levels, statin groupe (531 cases) and non statin groupe (439 cases). Cox regression analysis was used to confirm the associations of lipid levels and prognosis of the patients. Results:The different of mortality in each level of HDL-C was significant (P＜0.05), but there was no significant association between the levels of the TC, TG, LDL-C and prognosis (P＞0.05). Compared with living groupe, death patients were older, had more proportion of old myocardial infarction, anemia, atrial fibrillation and renal failure, while had lower HDL-C level and ejection factor, less using of angiotensin converting enzyme inhibitor(ACEI)/Angiotension receptor blocker(ARB) and statin (P<0.05 or P<0.01). Multivariate Cox regress analysis showed age, NYHAⅢ～Ⅳ, the lowest and the lower level HDL-C had significantly greater survival. ACEI/ARB was protected factor for prognosis. But none of the quartiles of TC or TG or LDL-C could predict for the mortality. Conclusion:Our study shows HDL-C represented a novel prognostic factor for patients with advanced heart failure. TC, TG and LDL-C were not related to the prognosis of heart failure.

Key words: coronary diseaseheart failurecholesterol cholesterol, LDL cholesterol, HDLtriglycerides statinsprognosis, 甘油三酯类