Purpose: To evaluate the prevalence and associations of non-cardiac comorbidities (NCC) with in-hospital and post-discharge outcomes in acute heart failure (AHF) across the ejection fraction (EF) spectrum. Methods: 9326 AHF patients from ESC-HFA-EORP-HF-Long-Term-Registry had complete information for the following 12 NCCs: anemia, chronic obstructive pulmonary disease (COPD), diabetes, depression, hepatic dysfunction, renal dysfunction, malignancy, Parkinson disease, peripheral vascular disease (PVD), rheumatoid arthritis, sleep apnoea, stroke/TIA(transient ischemic attack). Patients were classified by number of NCCs (0, 1, 2, 3, and ≥4). Results: Of AHF patients, 20.5% had no NCC, 28.5% had 1 NCC, 23.1% had 2 NCC, 15.4% had 3 NCC and 12.5% had ≥4 NCC. In-hospital and post-discharge mortality increased with number of NCCs from 3.0% and 18.5% for 1 NCC to 12.5% and 36% for ≥4 NCCs.Anemia, COPD, PVD, sleep apnoea, rheumatoid arthritis, stroke/TIA, Parkinson and depression were more prevalent in HFpEF. The hazard ratio (95% confidence interval) for post-discharge death for each NCC was for anemia 1.6 (1.4-1.8), diabetes 1.2 (1.1-1.4), kidney dysfunction 1.7 (1.5-1.9), COPD 1.4 (1.2-1.5), PVD 1.2 (1.1-1.4), stroke/TIA 1.3 (1.1-1.5), depression 1.2 (1.0-1.5), haepatic dysfunction 2.1 (1.8-2.5), malignancy 1.5 (1.2-1.8), sleep apnoea 1.2 (0.9-1.7), rheumatoid arthritis 1.5 (1.1-2.1) and Parkinson 1.4 (0.9-2.1). Anemia, kidney dysfunction, COPD and diabetes were associated with post-discharge mortality in all EF categories, PVD, stroke/TIA and depression only in HFrEF and sleep apnoea and malignancy only in HFpEF. Conclusion: Multiple NCCs conferred poor in-hospital and post-discharge outcomes. EF categories had different prevalence and risk profile associated with individual NCCs.

Comprehensive Characterization of Non-Cardiac Comorbidities in Acute Heart Failure- an analysis of ESC-HFA EORP Heart Failure Long-Term Registry / O. Chioncel, L. Benson, M.G. Crespo-Leiro, S.D. Anker, A.J.S. Coats, G. Filippatos, T. Mcdonagh, C. Margineanu, A. Mebazaa, M. Metra, M.F. Piepoli, M. Adamo, G.M.C. Rosano, F. Ruschitzka, G. Savarese, P. Seferovic, M. Volterrani, R. Ferrari, A.P. Maggioni, L.H. Lund. - In: EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY. - ISSN 2047-4873. - (2023 May 13), pp. zwad151.1-zwad151.13. [10.1093/eurjpc/zwad151]

Comprehensive Characterization of Non-Cardiac Comorbidities in Acute Heart Failure- an analysis of ESC-HFA EORP Heart Failure Long-Term Registry

M.F. Piepoli;R. Ferrari;
2023

Abstract

Purpose: To evaluate the prevalence and associations of non-cardiac comorbidities (NCC) with in-hospital and post-discharge outcomes in acute heart failure (AHF) across the ejection fraction (EF) spectrum. Methods: 9326 AHF patients from ESC-HFA-EORP-HF-Long-Term-Registry had complete information for the following 12 NCCs: anemia, chronic obstructive pulmonary disease (COPD), diabetes, depression, hepatic dysfunction, renal dysfunction, malignancy, Parkinson disease, peripheral vascular disease (PVD), rheumatoid arthritis, sleep apnoea, stroke/TIA(transient ischemic attack). Patients were classified by number of NCCs (0, 1, 2, 3, and ≥4). Results: Of AHF patients, 20.5% had no NCC, 28.5% had 1 NCC, 23.1% had 2 NCC, 15.4% had 3 NCC and 12.5% had ≥4 NCC. In-hospital and post-discharge mortality increased with number of NCCs from 3.0% and 18.5% for 1 NCC to 12.5% and 36% for ≥4 NCCs.Anemia, COPD, PVD, sleep apnoea, rheumatoid arthritis, stroke/TIA, Parkinson and depression were more prevalent in HFpEF. The hazard ratio (95% confidence interval) for post-discharge death for each NCC was for anemia 1.6 (1.4-1.8), diabetes 1.2 (1.1-1.4), kidney dysfunction 1.7 (1.5-1.9), COPD 1.4 (1.2-1.5), PVD 1.2 (1.1-1.4), stroke/TIA 1.3 (1.1-1.5), depression 1.2 (1.0-1.5), haepatic dysfunction 2.1 (1.8-2.5), malignancy 1.5 (1.2-1.8), sleep apnoea 1.2 (0.9-1.7), rheumatoid arthritis 1.5 (1.1-2.1) and Parkinson 1.4 (0.9-2.1). Anemia, kidney dysfunction, COPD and diabetes were associated with post-discharge mortality in all EF categories, PVD, stroke/TIA and depression only in HFrEF and sleep apnoea and malignancy only in HFpEF. Conclusion: Multiple NCCs conferred poor in-hospital and post-discharge outcomes. EF categories had different prevalence and risk profile associated with individual NCCs.
Acute heart failure; Comorbidities; Prognosis
Settore MED/11 - Malattie dell'Apparato Cardiovascolare
13-mag-2023
Article (author)
File in questo prodotto:
File Dimensione Formato  
Chioncel_EJPC_zwad151.pdf

accesso riservato

Descrizione: Full Research Paper
Tipologia: Publisher's version/PDF
Dimensione 881.91 kB
Formato Adobe PDF
881.91 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/980509
Citazioni
  • ???jsp.display-item.citation.pmc??? 2
  • Scopus 12
  • ???jsp.display-item.citation.isi??? 10
social impact