Long-Term Abnormalities of Lipid Profile After a Single Episode of Sepsis

Background: Acute disturbances of the lipid profile are commonplace during acute sepsis episode. However, their long-term persistence has not to be investigated despite pivotal role of dyslipidemia in several comorbidities excessively noted in sepsis survivors (stroke, cardiomyopathy).Methods: A tot...

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Autores principales:	Nicholas Felici, Da Liu, Josh Maret, Mariana Restrepo, Yuliya Borovskiy, Jihane Hajj, Wesley Chung, Krzysztof Laudanski
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	sepsis lipids C-reactive protein atherosclerosis statin gender Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/7dd96e09ab8f4eada2ab66f37a35ae89
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spelling	oai:doaj.org-article:7dd96e09ab8f4eada2ab66f37a35ae892021-11-15T06:06:23ZLong-Term Abnormalities of Lipid Profile After a Single Episode of Sepsis2297-055X10.3389/fcvm.2021.674248https://doaj.org/article/7dd96e09ab8f4eada2ab66f37a35ae892021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fcvm.2021.674248/fullhttps://doaj.org/toc/2297-055XBackground: Acute disturbances of the lipid profile are commonplace during acute sepsis episode. However, their long-term persistence has not to be investigated despite pivotal role of dyslipidemia in several comorbidities excessively noted in sepsis survivors (stroke, cardiomyopathy).Methods: A total of 9,861 individuals hospitalized for a singular episode of sepsis between 2009 and 2019 were identified from electronic medical records. Lab measurements of total cholesterol (Tchol), high-density lipoprotein (HDL-c), low-density lipoprotein (LDL-c), very low-density lipoprotein (VLDL), triglycerides (TG), lipoprotein(a) [Lp (a)], apolipoprotein B (ApoB), and C-reactive protein (CRP). The data were examined as baseline values before sepsis, during hospitalization, and <3 months, 3–6 months, 6–12 months, 1–2 years, and more than 2 years from initial sepsis.Results: Significant reductions in HDL-c (HDLbaseline = 44.06 vs. HDLsepsis = 28.2; U = −37.79, p < 0.0001, Cohen's d = 0.22) and LDL-c serum levels were observed during and up to three months post sepsis, with females much less affected. In contrast, male subjects had derangement in HDL present for up to two years after a singular septic episode. Total cholesterol levels were slightly yet significantly elevated for up to two years after sepsis. TG were elevated up to one year [TGbaseline = 128.26 vs. TGsepsis = 170.27, t(8255) = −21.33, p < 0.0001, Cohen's d = 0.49] and normalized. Lp(a) was elevated up to two years after initial episode [Lp(a)baseline = 24.6 ± 16.06; Lp(a)sepsis−2year = 8.25 ± 5.17; Lp(a)morethan2years = 61.4 ± 40.1; ANOVA F(2, 24) = 7.39; p = 0.0032]. Response to statin therapy was blunted in sepsis survivors for several years after sepsis resolution. Significant drop-out in prescription of statins and niacin after sepsis was observed. Serum high sensitivity C-reactive protein was elevated for up to five years after sepsis resolution (H [6;1685] = 502.2; p < 0.0001).Discussion: Lipid abnormalities persisted long after the initial septic insult suggesting potential role in accelerating atherosclerosis and other abnormalities. In addition, sepsis seems to blunt statin effectiveness. Additionally, a significant and unexplained drop in statin use was seen in post-septic period.Conclusions: Our study suggests that persistent derangements of lipid profile components for up to two years after sepsis may be associated with altered risk of atherosclerosis-related events among sepsis survivors.Nicholas FeliciDa LiuJosh MaretMariana RestrepoYuliya BorovskiyYuliya BorovskiyJihane HajjWesley ChungKrzysztof LaudanskiKrzysztof LaudanskiKrzysztof LaudanskiFrontiers Media S.A.articlesepsislipidsC-reactive proteinatherosclerosisstatingenderDiseases of the circulatory (Cardiovascular) systemRC666-701ENFrontiers in Cardiovascular Medicine, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	sepsis lipids C-reactive protein atherosclerosis statin gender Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	sepsis lipids C-reactive protein atherosclerosis statin gender Diseases of the circulatory (Cardiovascular) system RC666-701 Nicholas Felici Da Liu Josh Maret Mariana Restrepo Yuliya Borovskiy Yuliya Borovskiy Jihane Hajj Wesley Chung Krzysztof Laudanski Krzysztof Laudanski Krzysztof Laudanski Long-Term Abnormalities of Lipid Profile After a Single Episode of Sepsis
description	Background: Acute disturbances of the lipid profile are commonplace during acute sepsis episode. However, their long-term persistence has not to be investigated despite pivotal role of dyslipidemia in several comorbidities excessively noted in sepsis survivors (stroke, cardiomyopathy).Methods: A total of 9,861 individuals hospitalized for a singular episode of sepsis between 2009 and 2019 were identified from electronic medical records. Lab measurements of total cholesterol (Tchol), high-density lipoprotein (HDL-c), low-density lipoprotein (LDL-c), very low-density lipoprotein (VLDL), triglycerides (TG), lipoprotein(a) [Lp (a)], apolipoprotein B (ApoB), and C-reactive protein (CRP). The data were examined as baseline values before sepsis, during hospitalization, and <3 months, 3–6 months, 6–12 months, 1–2 years, and more than 2 years from initial sepsis.Results: Significant reductions in HDL-c (HDLbaseline = 44.06 vs. HDLsepsis = 28.2; U = −37.79, p < 0.0001, Cohen's d = 0.22) and LDL-c serum levels were observed during and up to three months post sepsis, with females much less affected. In contrast, male subjects had derangement in HDL present for up to two years after a singular septic episode. Total cholesterol levels were slightly yet significantly elevated for up to two years after sepsis. TG were elevated up to one year [TGbaseline = 128.26 vs. TGsepsis = 170.27, t(8255) = −21.33, p < 0.0001, Cohen's d = 0.49] and normalized. Lp(a) was elevated up to two years after initial episode [Lp(a)baseline = 24.6 ± 16.06; Lp(a)sepsis−2year = 8.25 ± 5.17; Lp(a)morethan2years = 61.4 ± 40.1; ANOVA F(2, 24) = 7.39; p = 0.0032]. Response to statin therapy was blunted in sepsis survivors for several years after sepsis resolution. Significant drop-out in prescription of statins and niacin after sepsis was observed. Serum high sensitivity C-reactive protein was elevated for up to five years after sepsis resolution (H [6;1685] = 502.2; p < 0.0001).Discussion: Lipid abnormalities persisted long after the initial septic insult suggesting potential role in accelerating atherosclerosis and other abnormalities. In addition, sepsis seems to blunt statin effectiveness. Additionally, a significant and unexplained drop in statin use was seen in post-septic period.Conclusions: Our study suggests that persistent derangements of lipid profile components for up to two years after sepsis may be associated with altered risk of atherosclerosis-related events among sepsis survivors.
format	article
author	Nicholas Felici Da Liu Josh Maret Mariana Restrepo Yuliya Borovskiy Yuliya Borovskiy Jihane Hajj Wesley Chung Krzysztof Laudanski Krzysztof Laudanski Krzysztof Laudanski
author_facet	Nicholas Felici Da Liu Josh Maret Mariana Restrepo Yuliya Borovskiy Yuliya Borovskiy Jihane Hajj Wesley Chung Krzysztof Laudanski Krzysztof Laudanski Krzysztof Laudanski
author_sort	Nicholas Felici
title	Long-Term Abnormalities of Lipid Profile After a Single Episode of Sepsis
title_short	Long-Term Abnormalities of Lipid Profile After a Single Episode of Sepsis
title_full	Long-Term Abnormalities of Lipid Profile After a Single Episode of Sepsis
title_fullStr	Long-Term Abnormalities of Lipid Profile After a Single Episode of Sepsis
title_full_unstemmed	Long-Term Abnormalities of Lipid Profile After a Single Episode of Sepsis
title_sort	long-term abnormalities of lipid profile after a single episode of sepsis
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/7dd96e09ab8f4eada2ab66f37a35ae89
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Long-Term Abnormalities of Lipid Profile After a Single Episode of Sepsis

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