Author + information
- Sukhdeep S. Basra,
- Mirza Umair Khalid,
- Ravi Hira,
- Salman Bandeali,
- Salim Virani,
- Vijay Nambi,
- David Aguilar,
- Hani Jneid,
- Biykem Bozkurt and
- Anita Deswal
Although the majority of patients with heart failure with preserved ejection fraction (HFpEF) are treated as outpatients, there is paucity of information on the contribution of comorbidities to hospitalizations in ambulatory cohorts.
We examined the prognostic significance of comorbidites to HF hospitalizations and all-cause hospitalizations in a national cohort of HFpEF patients from 153 Veterans Affairs clinics. Cox proportional multivariate hazards models were constructed to evaluate the effect of comorbidities on outcomes.
In 2526 ambulatory patients with HFpEF (mean age 71 years), 12.2% had a HF hospitalization and 53% had any hospitalization over 2 years followup. The prevalence and adjusted hazard ratios for key comorbidities are shown. The risk of HF hospitalization increased with increasing body mass index (BMI), chronic kidney disease (CKD), anemia, peripheral arterial disease (PAD) and atrial fibrillation. Diabetes, chronic obstructive pulmonary disease (COPD), systolic blood pressure and age were not associated with HF hospitalization. All cause hospitalizations were independently associated with anemia, atrial fibrillation, COPD and PAD, although increasing age, BMI, CKD, and diabetes mellitus had no significant impact on all cause hospitalizations.
Comorbidities significantly influence hospitalizations in HFpEF. Aggressive management of comorbidities may help prevent the high hospitalization burden in these patients.
|Prevalence (%)||HF Hospitalizations||All Cause Hospitalizations|
|Age||0.99 (0.98–1.01)||1.03 (0.86–1.23)|
|Female Gender||9.1%||0.92 (0.61–1.41)||1.13 (0.93–1.35)|
|Diabetes Mellitus||44.9||1.07 (0.85–1.37)||1.08 (0.96–1.21)|
|Previous Myocardial Infarction||27.2||1.01 (0.77–1.31)||1.08 (0.92–1.22)|
|Peripheral Artery Disease||28.5||1.41 (1.11–1.80)||1.23 (1.09–1.39)|
|COPD||35.4||0.98 (0.77–1.25)||1.24 (1.10–1.38)|
|Atrial Fibrillation||35.6||1.70 (1.34–2.14)||1.18 (1.06–1.33)|
|CKD (GFR < 60 ml/kg/1.73 m2)||51.8||1.58 (1.23–2.04)||1.03 (0.93–1.16)|
|Anemia||36.8||1.88 (1.48–2.40)||1.49 (1.33–1.66)|
|BMI < 25 Kg/m2 (Reference)||18.9||1.00|
|25–29.9 Kg/m2||30.1||1.26 (0.87–1.83)|
|30–39.9 Kg/m2||38.9||1.60 (1.11–2.31)|
|> 40 Kg/m2||12.1||1.88 (1.19–2.96)|
|SBP 100–120 mm Hg (Reference)||26.8||1.00|
|< 100 mm Hg||4.3||1.55 (0.93–2.58)|
|121–140 mm Hg||38.7||1.02 (0.75–1.37)|
|141–160 mm Hg||21.1||1.21 (0.87–1.68)|
|> 160 mm Hg||9.1||1.14 (0.75–1.75)|
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Improving Heart Failure Outcomes II
Abstract Category: 28. Quality of Care and Outcomes Assessment
Presentation Number: 1200-102
- 2013 American College of Cardiology Foundation