Association between cardiovascular vs. non‐cardiovascular co‐morbidities and outcomes in heart failure with preserved ejection fraction

Lund, Lars H.; Donal, Erwan; Oger, Emmanuel; Hage, Camilla; Persson, Hans; Haugen-Löfman, Ida; Ennezat, Pierre‐Vladimir; Sportouch, Catherine; Drouet, Élodie; Daubert, Jean‐Claude; Linde, Cecilia

doi:10.1002/ejhf.137

Cited by 119 publications

(95 citation statements)

References 39 publications

(102 reference statements)

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“…However, each increment of AHEAD score was associated with 55% and 25% increasing risks of death in HFrEF and HFpEF, respectively. The results may support a better performance of AHEAD score in patients with HFrEF, and the heterogeneous pathophysiology of HFpEF that subjects with HFpEF have is more strongly associated with noncardiovascular comorbidity and aging 19, 20. In the adjusted Cox regression model, AHEAD was still associated with all‐cause and cardiovascular mortality in subjects with either HFrEF or HFpEF, indicating the AHEAD score was still a prognostic factor in both phenotypic HF.…”

Section: Discussionmentioning

confidence: 60%

Performance of AHEAD Score in an Asian Cohort of Acute Heart Failure With Either Preserved or Reduced Left Ventricular Systolic Function

Chen

Sung

Cheng

et al. 2017

JAHA

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Background AHEAD (A: atrial fibrillation; H: hemoglobin; E: elderly; A: abnormal renal parameters; D: diabetes mellitus) score has been related to clinical outcomes of acute heart failure. However, the prognostic value of the AHEAD score in acute heart failure patients with either reduced or preserved left ventricular ejection fraction (HFrEF and HFpEF) remain to be elucidated.Methods and ResultsThe study population consisted of 2143 patients (age 77±12 years, 68% men, 38% HFrEF) hospitalized primarily for acute heart failure with a median follow‐up of 23.75 months. The performance of the AHEAD score (atrial fibrillation, hemoglobin <13 mg/dL for men and 12 mg/dL for women, age >70 years, creatinine >130 μmol/L, and diabetes mellitus) was evaluated by Cox's regression analysis for predicting cardiovascular and all‐cause mortality. The mean AHEAD scores were 2.7±1.2 in the total study population, 2.6±1.3 in the HFrEF group, and 2.7±1.1 in the HFpEF group. After accounting for sex, sodium, uric acid, and medications, the AHEAD score remained significantly associated with all‐cause and cardiovascular mortality (hazard ratio and 95% CI: 1.49, 1.38–1.60 and 1.48, 1.33–1.64), respectively. The associations of AHEAD score with mortality remained significant in the subgroups of HFrEF (1.63, 1.47–1.82) and HFpEF (1.34, 1.22–1.48). Moreover, when we calculated a new AHEAD‐U score by considering uric acid (>8.6 mg/dL) in addition to the AHEAD score, the net reclassification was improved by 19.7% and 20.1% for predicting all‐cause and cardiovascular mortality, respectively.ConclusionsThe AHEAD score was useful in predicting long‐term mortality in the Asian acute heart failure cohort with either HFrEF or HFpEF. The new AHEAD‐U score may further improve risk stratification.

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Section: Discussionmentioning

confidence: 60%

Performance of AHEAD Score in an Asian Cohort of Acute Heart Failure With Either Preserved or Reduced Left Ventricular Systolic Function

Chen

Sung

Cheng

et al. 2017

JAHA

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“…There is regional variability in the prevalence of CAD in patients with HFpEF 5, 8, 9. In addition, population‐based reports suggest that HFpEF can be associated with CAD and is more prevalent in elderly women with a history of hypertension or diabetes mellitus 10.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Long‐Term Survival After Coronary Artery Bypass Grafting in Women and Men With Heart Failure and Preserved Versus Reduced Ejection Fraction

Sun

Eddeen

2018

JAHA

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BackgroundHeart failure (HF) with reduced ejection fraction (rEF) is a widely regarded prognosticator after coronary artery bypass grafting. HF with preserved ejection fraction (pEF) accounts for up to half of all HF cases and is associated with considerable morbidity and mortality in hospitalized cohorts. However, HFpEF outcomes have not been elucidated in cardiac surgical patients. We investigated the prevalence and outcomes of HFpEF and HFrEF in women and men following coronary artery bypass grafting.Methods and ResultsWe conducted a retrospective cohort study in Ontario, Canada, between October 1, 2008, and March 31, 2015, using Cardiac Care Network and Canadian Institute of Health Information data. HF is captured through a validated population‐based database of all Ontarians with physician‐diagnosed HF. We defined pEF as ejection fraction ≥50% and rEF as ejection fraction <50%. The primary outcome was all‐cause mortality. Analyses were stratified by sex. Mortality rates were calculated using Kaplan–Meier method. The relative hazard of death was assessed using multivariable Cox proportional hazard models. Of 40 083 patients (20.6% women), 55.5% had pEF without HF, 25.7% had rEF without HF, 6.9% had HFpEF, and 12.0% had HFrEF. Age‐standardized HFpEF mortality rates at 4±2 years of follow‐up were similar in women and men. HFrEF standardized HFpEF mortality rates were higher in women than men.ConclusionsWe found a higher prevalence and poorer prognosis of HFpEF in women. A history of HF was a more important prognosticator than ejection fraction. Preoperative screening and extended postoperative follow‐up should be focused on women and men with HF rather than on rEF alone.

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“…432 Furthermore, hemodilution frequently observed in ADHF patients 433 with newly diagnosed anemia was recognized as a potent 434 independent predictor of new-onset anemia. Interestingly, anemia 435 might also influence the prognosis of patients with HF and 436 preserved EF [60]. 437 To conclude, although it was demonstrated that hemoconcen-438 tration is significantly associated with aggressive fluid removal 439 and transient renal function deterioration, it improves survival, 440 which implicates the importance of aggressive decongestion 441 during hospital admission [53].…”

mentioning

confidence: 99%

Anemia in Intensive Cardiac Care Unit patients – An underestimated problem

Uscinska

Idźkowska

Sobkowicz

et al. 2015

Advances in Medical Sciences

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Association between cardiovascular vs. non‐cardiovascular co‐morbidities and outcomes in heart failure with preserved ejection fraction

Cited by 119 publications

References 39 publications

Performance of AHEAD Score in an Asian Cohort of Acute Heart Failure With Either Preserved or Reduced Left Ventricular Systolic Function

Performance of AHEAD Score in an Asian Cohort of Acute Heart Failure With Either Preserved or Reduced Left Ventricular Systolic Function

Prevalence and Long‐Term Survival After Coronary Artery Bypass Grafting in Women and Men With Heart Failure and Preserved Versus Reduced Ejection Fraction

Anemia in Intensive Cardiac Care Unit patients – An underestimated problem

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