Author + information
- Kishan S. Parikh,
- Daniel Forman,
- Daniel Wojdyla,
- Robert Mentz,
- Jerome Fleg,
- William Kraus and
- Dalane Kitzman
Background: The population with heart failure (HF) with reduced ejection fraction (HFrEF) is generally older, and presence of comorbid conditions is increasingly relevant to their management. We investigated the relationship between age, comorbidities, and adverse outcomes among subjects in the HF-ACTION trial of exercise training versus usual care in patients with HFrEF.
Methods: All 2,331 subjects in HF-ACTION (median age 59 years, 28.4% women, follow-up 2.5 years) were included in our study. Outcomes of interest were all-cause mortality/ all-cause hospitalization, and all-cause mortality. We developed a Cox proportional hazards model including covariates known to affect outcomes in HF-ACTION and age, and added individual comorbidities to assess changes in the age regression coefficient. We also tested the interactions between age and comorbidities treating p-value <.1 as statistically significant.
Results: Age was not associated with increased risk for all-cause mortality/ hospitalization, but was associated with all-cause mortality (adjusted HR 1.09, p=.03). Changes in model coefficient and interaction p-values are shown in Table 1.
Conclusions: In a large HFrEF cohort, age was not associated with morbidity. The association of age with all-cause mortality is strengthened when body mass index, depression, and chronic obstructive pulmonary disease are accounted for. These findings show a nuanced consideration of comorbidities may be needed in assessing outcomes of patients with HFrEF.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Emerging Developments in HFpEF and Arryhthmias
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1250-295
- 2017 American College of Cardiology Foundation