Koen W Streng1, Jan F Nauta1, Hans L Hillege1, Stefan D Anker2, John G Cleland3, Kenneth Dickstein4, Gerasimos Filippatos5, Chim C Lang6, Marco Metra7, Leong L Ng8, Piotr Ponikowski9, Nilesh J Samani8, Dirk J van Veldhuisen1, Aeilko H Zwinderman10, Faiez Zannad11, Kevin Damman1, Peter van der Meer1, Adriaan A Voors12. 1. University of Groningen, Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands. 2. Innovative Clinical Trials, Department of Cardiology and Pneumology, University Medical Centre Göttingen (UMG), Göttingen, Germany. 3. National Heart & Lung Institute, Royal Brompton and Harefield Hospitals, Imperial College, London, UK. 4. University of Bergen, Bergen, Norway; Stavanger University Hospital, Stavanger, Norway. 5. National and Kapodistrian University of Athens, School of Medicine, Department of Cardiology, Heart Failure Unit, Athens University Hospital Attikon, Athens, Greece. 6. School of Medicine Centre for Cardiovascular and Lung Biology, Division of Medical Sciences, University of Dundee, Ninewells Hospital & Medical School, Dundee, UK. 7. Institute of Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Italy. 8. Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester LE3 9QP, UK. 9. Department of Heart Diseases, Wroclaw Medical University, Poland and Cardiology Department, Military Hospital, Wroclaw, Poland. 10. Department of Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, Amsterdam, The Netherlands. 11. Inserm CIC 1433, Université de Lorrain, CHU de Nancy, Nancy, France. 12. University of Groningen, Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands. Electronic address: a.a.voors@umcg.nl.
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.
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.
Authors: Mayra Tisminetzky; Jerry H Gurwitz; Dongjie Fan; Kristi Reynolds; David H Smith; Hassan Fouayzi; Sue Hee Sung; Robert Goldberg; Alan S Go Journal: J Gerontol A Biol Sci Med Sci Date: 2020-09-25 Impact factor: 6.053
Authors: A Hagendorff; A Helfen; R Brandt; E Altiok; O Breithardt; D Haghi; J Knierim; D Lavall; N Merke; C Sinning; S Stöbe; C Tschöpe; F Knebel; S Ewen Journal: Clin Res Cardiol Date: 2022-06-04 Impact factor: 5.460
Authors: Ankeet S Bhatt; Andrew P Ambrosy; Allison Dunning; Adam D DeVore; Javed Butler; Shelby Reed; Adriaan Voors; Randall Starling; Paul W Armstrong; Justin A Ezekowitz; Marco Metra; Adrian F Hernandez; Christopher M O'Connor; Robert J Mentz Journal: Eur J Heart Fail Date: 2020-03-25 Impact factor: 15.534