Predictors of long-term outcome in heart failure with preserved ejection fraction: a follow-up from the KaRen study.
Diastolic heart failure
HFpEF
Mortality
Predictors
Prognosis
Journal
ESC heart failure
ISSN: 2055-5822
Titre abrégé: ESC Heart Fail
Pays: England
ID NLM: 101669191
Informations de publication
Date de publication:
10 2021
10 2021
Historique:
revised:
20
06
2021
received:
19
04
2021
accepted:
05
07
2021
pubmed:
11
8
2021
medline:
30
10
2021
entrez:
10
8
2021
Statut:
ppublish
Résumé
Heart failure (HF) with preserved ejection fraction (HFpEF) has poor long-term prognosis. We assessed rates and predictors of outcome 10 years after an acute episode of HF. The Karolinska-Rennes (KaRen) study enrolled HFpEF patients with acute HF, ejection fraction ≥ 45%, and N-terminal pro-brain natriuretic peptide > 300 ng/L in 2007-11. Clinical data were collected at enrolment and after 4-8 weeks including detailed echocardiography. Follow-up data were collected 10 years after study initiation, starting from 6 months after enrolment until 2018 assessed by telephone. Independent predictors of primary (all-cause mortality or HF hospitalization) and secondary (all-cause mortality) outcomes were assessed by multivariable Cox regression. Of 539 patients, long-term follow-up data were available for 397 patients [52% female; median (interquartile range) age 79 (73, 84) years]. Over a follow-up of 5.44 (2.06-7.89) years, 1, 3, 5, and 10 year mortality rates were 15%, 31%, 47%, and 74%, respectively, with an incidence rate of 130/1000 patient-years. The primary outcome was met in 84% of the population, with an incidence rate of 227/1000 patient-years. The independent predictors of the primary outcome were tricuspid regurgitation peak velocity (m/s) [hazard ratio 1.87 (1.34-2.62)], diabetes mellitus [1.75 (1.11-2.74)], and cancer [1.75 (1.01-3.03)] while female sex was associated with reduced risk [0.64 (0.41-0.98)]. In HFpEF, 1, 3, 5, and 10 year mortality was 15%, 31%, 47%, and 74% and mortality or first HF hospitalization was 35%, 54%, 67%, and 84%, respectively. Independent predictors of mortality or HF hospitalization were tricuspid regurgitation peak velocity, diabetes mellitus, cancer, and male sex. In clinical management of HFpEF, attention should be paid to both cardiac and non-cardiac conditions.
Identifiants
pubmed: 34374216
doi: 10.1002/ehf2.13533
pmc: PMC8497206
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
4243-4254Informations de copyright
© 2021 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.
Références
N Engl J Med. 2014 Apr 10;370(15):1383-92
pubmed: 24716680
J Am Coll Cardiol. 2009 Mar 31;53(13):1119-26
pubmed: 19324256
Eur J Heart Fail. 2014 May;16(5):535-42
pubmed: 24574260
ESC Heart Fail. 2021 Oct;8(5):4243-4254
pubmed: 34374216
N Engl J Med. 2019 Oct 24;381(17):1609-1620
pubmed: 31475794
Int J Cardiol. 2011 Mar 3;147(2):278-82
pubmed: 19896733
JACC Heart Fail. 2019 Jun;7(6):505-515
pubmed: 31146874
J Am Coll Cardiol. 2019 Dec 10;74(23):2858-2873
pubmed: 31806129
J Cardiol. 2019 Sep;74(3):235-244
pubmed: 30910388
J Card Fail. 2019 Dec;25(12):978-985
pubmed: 31344403
Am J Cardiol. 2005 Apr 15;95(8):1020-3
pubmed: 15820183
Clin Res Cardiol. 2019 Dec;108(12):1394-1405
pubmed: 30980205
N Engl J Med. 2006 Jul 20;355(3):260-9
pubmed: 16855266
N Engl J Med. 2010 Dec 16;363(25):2385-95
pubmed: 21073365
Int J Cardiol. 2017 Dec 1;248:239-245
pubmed: 28821416
N Engl J Med. 2006 Jul 20;355(3):251-9
pubmed: 16855265
Eur J Heart Fail. 2014 Sep;16(9):967-76
pubmed: 25111982
Card Fail Rev. 2017 Apr;3(1):7-11
pubmed: 28785469
Eur Heart J. 2016 Jul 14;37(27):2129-2200
pubmed: 27206819
Eur Heart J. 2012 Jul;33(14):1750-7
pubmed: 21821849
J Am Coll Cardiol. 2017 Nov 14;70(20):2476-2486
pubmed: 29141781
Eur J Heart Fail. 2014 Sep;16(9):992-1001
pubmed: 25046483
J Cardiovasc Ultrasound. 2010 Mar;18(1):1-5
pubmed: 20661328
Circ Heart Fail. 2016 Nov;9(11):
pubmed: 28029640
Eur Heart J. 2010 Sep;31(18):2280-90
pubmed: 20693169
Eur J Heart Fail. 2015 Jul;17(7):680-8
pubmed: 26033771
Eur J Heart Fail. 2018 Sep;20(9):1257-1266
pubmed: 29917301
J Am Soc Echocardiogr. 2015 Jan;28(1):1-39.e14
pubmed: 25559473
Lancet. 2003 Sep 6;362(9386):777-81
pubmed: 13678871
Eur J Heart Fail. 2009 Feb;11(2):198-204
pubmed: 19168519
JACC Heart Fail. 2017 Aug;5(8):565-574
pubmed: 28711451
J Am Coll Cardiol. 2013 Jul 23;62(4):263-71
pubmed: 23684677
Eur Heart J. 2019 Oct 21;40(40):3297-3317
pubmed: 31504452