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Long‐term outcomes in heart failure with preserved ejection fraction: Predictors of cardiac and non‐cardiac mortality

AIMS: Heart failure (HF) with preserved ejection fraction (HFpEF) is associated with cardiovascular (CV) and non‐CV events, but long‐term risk is poorly studied. We assessed incidence and predictors of the long‐term CV and non‐CV events. METHODS AND RESULTS: Patients presenting with acute HF, EF ≥ 4...

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Autores principales: Shahim, Angiza, Hourqueig, Marion, Lund, Lars H., Savarese, Gianluigi, Oger, Emmanuel, Venkateshvaran, Ashwin, Benson, Lina, Daubert, Jean‐Claude, Linde, Cecilia, Donal, Erwan, Hage, Camilla
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10192235/
https://www.ncbi.nlm.nih.gov/pubmed/36896796
http://dx.doi.org/10.1002/ehf2.14302
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author Shahim, Angiza
Hourqueig, Marion
Lund, Lars H.
Savarese, Gianluigi
Oger, Emmanuel
Venkateshvaran, Ashwin
Benson, Lina
Daubert, Jean‐Claude
Linde, Cecilia
Donal, Erwan
Hage, Camilla
author_facet Shahim, Angiza
Hourqueig, Marion
Lund, Lars H.
Savarese, Gianluigi
Oger, Emmanuel
Venkateshvaran, Ashwin
Benson, Lina
Daubert, Jean‐Claude
Linde, Cecilia
Donal, Erwan
Hage, Camilla
author_sort Shahim, Angiza
collection PubMed
description AIMS: Heart failure (HF) with preserved ejection fraction (HFpEF) is associated with cardiovascular (CV) and non‐CV events, but long‐term risk is poorly studied. We assessed incidence and predictors of the long‐term CV and non‐CV events. METHODS AND RESULTS: Patients presenting with acute HF, EF ≥ 45%, and N‐terminal pro‐brain natriuretic peptide > 300 ng/L were enrolled in the Karolinska‐Rennes study in 2007–11 and were reassessed after 4–8 weeks in a stable state. Long‐term follow‐up was conducted in 2018. The Fine–Gray sub‐distribution hazard regression was used to detect predictors of CV and non‐CV deaths, investigated separately from baseline acute presentation (demographic data only) and from the 4–8 week outpatient visit (including echocardiographic data). Of 539 patients enrolled [median age 78 (interquartile range: 72–84) years; 52% female], 397 patients were available for the long‐term follow‐up. Over a median follow‐up time from acute presentation of 5.4 (2.1–7.9) years, 269 (68%) patients died, 128 (47%) from CV and 120 (45%) from non‐CV causes. Incidence rates per 1000 patient‐years were 62 [95% confidence interval (CI) 52–74] for CV and 58 (95% CI 48–69) for non‐CV death. Higher age and coronary artery disease (CAD) were independent predictors of CV death, and anaemia, stroke, kidney disease, and lower body mass index (BMI) and sodium concentrations of non‐CV death. From the stable 4–8 week visit, anaemia, CAD, and tricuspid regurgitation (>3.1 m/s) were independent predictors of CV death, and higher age of non‐CV death. CONCLUSIONS: In patients with acute decompensated HFpEF, over 5 years of follow‐up, nearly two‐thirds of patients died, half from CV and the other half from non‐CV causes. CAD and tricuspid regurgitation were associated with CV death. Stroke, kidney disease, lower BMI, and lower sodium were associated with non‐CV death. Anaemia and higher age were associated with both outcomes. [Correction added on 24 March 2023, after first online publication: In the first sentence of the Conclusions, ‘two‐thirds’ has been inserted before ‘of patients died...’ in this version.]
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spelling pubmed-101922352023-05-19 Long‐term outcomes in heart failure with preserved ejection fraction: Predictors of cardiac and non‐cardiac mortality Shahim, Angiza Hourqueig, Marion Lund, Lars H. Savarese, Gianluigi Oger, Emmanuel Venkateshvaran, Ashwin Benson, Lina Daubert, Jean‐Claude Linde, Cecilia Donal, Erwan Hage, Camilla ESC Heart Fail Original Articles AIMS: Heart failure (HF) with preserved ejection fraction (HFpEF) is associated with cardiovascular (CV) and non‐CV events, but long‐term risk is poorly studied. We assessed incidence and predictors of the long‐term CV and non‐CV events. METHODS AND RESULTS: Patients presenting with acute HF, EF ≥ 45%, and N‐terminal pro‐brain natriuretic peptide > 300 ng/L were enrolled in the Karolinska‐Rennes study in 2007–11 and were reassessed after 4–8 weeks in a stable state. Long‐term follow‐up was conducted in 2018. The Fine–Gray sub‐distribution hazard regression was used to detect predictors of CV and non‐CV deaths, investigated separately from baseline acute presentation (demographic data only) and from the 4–8 week outpatient visit (including echocardiographic data). Of 539 patients enrolled [median age 78 (interquartile range: 72–84) years; 52% female], 397 patients were available for the long‐term follow‐up. Over a median follow‐up time from acute presentation of 5.4 (2.1–7.9) years, 269 (68%) patients died, 128 (47%) from CV and 120 (45%) from non‐CV causes. Incidence rates per 1000 patient‐years were 62 [95% confidence interval (CI) 52–74] for CV and 58 (95% CI 48–69) for non‐CV death. Higher age and coronary artery disease (CAD) were independent predictors of CV death, and anaemia, stroke, kidney disease, and lower body mass index (BMI) and sodium concentrations of non‐CV death. From the stable 4–8 week visit, anaemia, CAD, and tricuspid regurgitation (>3.1 m/s) were independent predictors of CV death, and higher age of non‐CV death. CONCLUSIONS: In patients with acute decompensated HFpEF, over 5 years of follow‐up, nearly two‐thirds of patients died, half from CV and the other half from non‐CV causes. CAD and tricuspid regurgitation were associated with CV death. Stroke, kidney disease, lower BMI, and lower sodium were associated with non‐CV death. Anaemia and higher age were associated with both outcomes. [Correction added on 24 March 2023, after first online publication: In the first sentence of the Conclusions, ‘two‐thirds’ has been inserted before ‘of patients died...’ in this version.] John Wiley and Sons Inc. 2023-03-10 /pmc/articles/PMC10192235/ /pubmed/36896796 http://dx.doi.org/10.1002/ehf2.14302 Text en © 2023 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Shahim, Angiza
Hourqueig, Marion
Lund, Lars H.
Savarese, Gianluigi
Oger, Emmanuel
Venkateshvaran, Ashwin
Benson, Lina
Daubert, Jean‐Claude
Linde, Cecilia
Donal, Erwan
Hage, Camilla
Long‐term outcomes in heart failure with preserved ejection fraction: Predictors of cardiac and non‐cardiac mortality
title Long‐term outcomes in heart failure with preserved ejection fraction: Predictors of cardiac and non‐cardiac mortality
title_full Long‐term outcomes in heart failure with preserved ejection fraction: Predictors of cardiac and non‐cardiac mortality
title_fullStr Long‐term outcomes in heart failure with preserved ejection fraction: Predictors of cardiac and non‐cardiac mortality
title_full_unstemmed Long‐term outcomes in heart failure with preserved ejection fraction: Predictors of cardiac and non‐cardiac mortality
title_short Long‐term outcomes in heart failure with preserved ejection fraction: Predictors of cardiac and non‐cardiac mortality
title_sort long‐term outcomes in heart failure with preserved ejection fraction: predictors of cardiac and non‐cardiac mortality
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10192235/
https://www.ncbi.nlm.nih.gov/pubmed/36896796
http://dx.doi.org/10.1002/ehf2.14302
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