Non-cardiac comorbidities in heart failure with reduced, mid-range and preserved ejection fraction
File(s)non_cardiac_comorbidities_in_hear_failure.pdf (1.03 MB)
Published version
OA Location
Author(s)
Type
Journal Article
Abstract
Background: Comorbidities play a major role in heart failure. Whether prevalence and prognostic importance of comorbidities differ between heart failure with preserved ejection fraction (HFpEF), mid-range (HFmrEF) or reduced ejection fraction (HFrEF) is unknown. Methods: Patients from index (n = 2516) and validation cohort (n = 1738) of The BIOlogy Study to TAilored Treatment in Chronic Heart Failure (BIOSTAT-CHF) were pooled. Eight non-cardiac comorbidities were assessed; diabetes mellitus, thyroid dysfunction, obesity, anaemia, chronic kidney disease (CKD, estimated glomerular filtration rate < 60 mL/min/1.73 m2), COPD, stroke and peripheral arterial disease. Patients were classified based on ejection fraction. The association of each comorbidity with quality of life (QoL), all-cause mortality and hospitalisation was evaluated. Results: Patients with complete comorbidity data were included (n = 3499). Most prevalent comorbidity was CKD (50%). All comorbidities showed the highest prevalence in HFpEF, except for stroke. Prevalences of HFmrEF were in between the other entities. COPD was the comorbidity associated with the greatest reduction in QoL. In HFrEF, almost all were associated with a significant reduction in QoL, while in HFpEF only CKD and obesity were associated with a reduction. Most comorbidities in HFrEF were associated with an increased mortality risk, while in HFpEF only CKD, anaemia and COPD were associated with higher mortality risks. Conclusions: The highest prevalence of comorbidities was seen in patients with HFpEF. Overall, comorbidities were associated with a lower QoL, but this was more pronounced in patients with HFrEF. Most comorbidities were associated with higher mortality risks, although the associations with diabetes were only present in patients with HFrEF.
Date Issued
2018-11-15
Date Acceptance
2018-04-02
Citation
International Journal of Cardiology, 2018, 271, pp.132-139
ISSN
0167-5273
Publisher
Elsevier
Start Page
132
End Page
139
Journal / Book Title
International Journal of Cardiology
Volume
271
Copyright Statement
© 2017 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Subjects
CKD
Comorbidities
Heart failure
Mortality
Quality of life
Aged
Aged, 80 and over
Cohort Studies
Comorbidity
Diabetes Mellitus
Female
Heart Failure
Humans
Male
Middle Aged
Renal Insufficiency, Chronic
Retrospective Studies
Stroke
Stroke Volume
Humans
Diabetes Mellitus
Stroke Volume
Retrospective Studies
Cohort Studies
Comorbidity
Aged
Aged, 80 and over
Middle Aged
Female
Male
Renal Insufficiency, Chronic
Heart Failure
Stroke
1102 Cardiorespiratory Medicine and Haematology
Cardiovascular System & Hematology
Publication Status
Published
Date Publish Online
2018-07-07