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Phenomapping in patients experiencing worsening renal function during hospitalization for acute heart failure

AIMS: The impact of worsening renal function (WRF) on the prognosis of patients with acute heart failure (AHF) remains controversial. We aimed to identify phenotypically distinct subgroups among individuals with both AHF and WRF using cluster analysis. METHODS AND RESULTS: Overall, the data of 483 p...

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Autores principales: Yagi, Ryuichiro, Takei, Makoto, Kohsaka, Shun, Shiraishi, Yasuyuki, Ikemura, Nobuhiro, Shoji, Satoshi, Niimi, Nozomi, Higuchi, Satoshi, Goda, Ayumi, Kohno, Takashi, Nagatomo, Yuji, Nishihata, Yosuke, Sujino, Yasumori, Saji, Mike, Ikegami, Yukinori, Nakano, Shintaro, Takahashi, Toshiyuki, Fukuda, Keiichi, Yoshikawa, Tsutomu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8712773/
https://www.ncbi.nlm.nih.gov/pubmed/34545703
http://dx.doi.org/10.1002/ehf2.13598
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author Yagi, Ryuichiro
Takei, Makoto
Kohsaka, Shun
Shiraishi, Yasuyuki
Ikemura, Nobuhiro
Shoji, Satoshi
Niimi, Nozomi
Higuchi, Satoshi
Goda, Ayumi
Kohno, Takashi
Nagatomo, Yuji
Nishihata, Yosuke
Sujino, Yasumori
Saji, Mike
Ikegami, Yukinori
Nakano, Shintaro
Takahashi, Toshiyuki
Fukuda, Keiichi
Yoshikawa, Tsutomu
author_facet Yagi, Ryuichiro
Takei, Makoto
Kohsaka, Shun
Shiraishi, Yasuyuki
Ikemura, Nobuhiro
Shoji, Satoshi
Niimi, Nozomi
Higuchi, Satoshi
Goda, Ayumi
Kohno, Takashi
Nagatomo, Yuji
Nishihata, Yosuke
Sujino, Yasumori
Saji, Mike
Ikegami, Yukinori
Nakano, Shintaro
Takahashi, Toshiyuki
Fukuda, Keiichi
Yoshikawa, Tsutomu
author_sort Yagi, Ryuichiro
collection PubMed
description AIMS: The impact of worsening renal function (WRF) on the prognosis of patients with acute heart failure (AHF) remains controversial. We aimed to identify phenotypically distinct subgroups among individuals with both AHF and WRF using cluster analysis. METHODS AND RESULTS: Overall, the data of 483 patients with both AHF and WRF enrolled in the West Tokyo Heart Failure Registry were analysed. Using cluster analysis, we identified three phenotypically distinct subgroups (phenogroups 1, 2, and 3). We assessed the impact of WRF on the prognosis of each phenogroup by comparing the incidence of composite endpoints, including all‐cause death and re‐hospitalization due to heart failure, with those of a propensity score‐matched, non‐WRF control group. Participants in phenogroup 1 (N = 122) were the youngest (69.3 ± 13.7 years), had relatively preserved estimated glomerular filtration rate (eGFR, 70.0 ± 27.7 mL/min/1.73 m(2)), and reduced left ventricular ejection fraction (LVEF) (41.8 ± 13.7%). Conversely, participants in phenogroup 3 (N = 122) were the oldest (81.7 ± 8.5 years), had the worst eGFR (33.0 ± 20.9 mL/min/1.73 m(2)), and had preserved LVEF (51.7 ± 14.8%). The characteristics of the participants in phenogroup 2 (N = 239) were between those of phenogroups 1 and 3. The propensity score matching analysis showed that WRF was associated with a higher incidence of composite endpoints in phenogroup 1, whereas this association was not observed in phenogroups 2 and 3. CONCLUSIONS: Using cluster analysis, we revealed three phenotypically distinct subgroups of patients with both AHF and WRF. WRF was associated with worse clinical outcomes in the subgroup of younger patients with reduced LVEF and preserved renal function.
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spelling pubmed-87127732022-01-04 Phenomapping in patients experiencing worsening renal function during hospitalization for acute heart failure Yagi, Ryuichiro Takei, Makoto Kohsaka, Shun Shiraishi, Yasuyuki Ikemura, Nobuhiro Shoji, Satoshi Niimi, Nozomi Higuchi, Satoshi Goda, Ayumi Kohno, Takashi Nagatomo, Yuji Nishihata, Yosuke Sujino, Yasumori Saji, Mike Ikegami, Yukinori Nakano, Shintaro Takahashi, Toshiyuki Fukuda, Keiichi Yoshikawa, Tsutomu ESC Heart Fail Original Articles AIMS: The impact of worsening renal function (WRF) on the prognosis of patients with acute heart failure (AHF) remains controversial. We aimed to identify phenotypically distinct subgroups among individuals with both AHF and WRF using cluster analysis. METHODS AND RESULTS: Overall, the data of 483 patients with both AHF and WRF enrolled in the West Tokyo Heart Failure Registry were analysed. Using cluster analysis, we identified three phenotypically distinct subgroups (phenogroups 1, 2, and 3). We assessed the impact of WRF on the prognosis of each phenogroup by comparing the incidence of composite endpoints, including all‐cause death and re‐hospitalization due to heart failure, with those of a propensity score‐matched, non‐WRF control group. Participants in phenogroup 1 (N = 122) were the youngest (69.3 ± 13.7 years), had relatively preserved estimated glomerular filtration rate (eGFR, 70.0 ± 27.7 mL/min/1.73 m(2)), and reduced left ventricular ejection fraction (LVEF) (41.8 ± 13.7%). Conversely, participants in phenogroup 3 (N = 122) were the oldest (81.7 ± 8.5 years), had the worst eGFR (33.0 ± 20.9 mL/min/1.73 m(2)), and had preserved LVEF (51.7 ± 14.8%). The characteristics of the participants in phenogroup 2 (N = 239) were between those of phenogroups 1 and 3. The propensity score matching analysis showed that WRF was associated with a higher incidence of composite endpoints in phenogroup 1, whereas this association was not observed in phenogroups 2 and 3. CONCLUSIONS: Using cluster analysis, we revealed three phenotypically distinct subgroups of patients with both AHF and WRF. WRF was associated with worse clinical outcomes in the subgroup of younger patients with reduced LVEF and preserved renal function. John Wiley and Sons Inc. 2021-09-20 /pmc/articles/PMC8712773/ /pubmed/34545703 http://dx.doi.org/10.1002/ehf2.13598 Text en © 2021 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
Yagi, Ryuichiro
Takei, Makoto
Kohsaka, Shun
Shiraishi, Yasuyuki
Ikemura, Nobuhiro
Shoji, Satoshi
Niimi, Nozomi
Higuchi, Satoshi
Goda, Ayumi
Kohno, Takashi
Nagatomo, Yuji
Nishihata, Yosuke
Sujino, Yasumori
Saji, Mike
Ikegami, Yukinori
Nakano, Shintaro
Takahashi, Toshiyuki
Fukuda, Keiichi
Yoshikawa, Tsutomu
Phenomapping in patients experiencing worsening renal function during hospitalization for acute heart failure
title Phenomapping in patients experiencing worsening renal function during hospitalization for acute heart failure
title_full Phenomapping in patients experiencing worsening renal function during hospitalization for acute heart failure
title_fullStr Phenomapping in patients experiencing worsening renal function during hospitalization for acute heart failure
title_full_unstemmed Phenomapping in patients experiencing worsening renal function during hospitalization for acute heart failure
title_short Phenomapping in patients experiencing worsening renal function during hospitalization for acute heart failure
title_sort phenomapping in patients experiencing worsening renal function during hospitalization for acute heart failure
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8712773/
https://www.ncbi.nlm.nih.gov/pubmed/34545703
http://dx.doi.org/10.1002/ehf2.13598
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