HMGCR and hydrops fetalis: Although lipid-lowering therapy with HMG-CoA reductase is recommended for patients with acute myocardial infarction, poor nutrition has a worse outcome in patients with HF, and low LDL levels were associated with worse outcomes than those in high LDL levels, known as the “lipid paradox.” Impaired myocardial energy production is associated with decreased ATP and phosphocreatine concentrations.