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Comorbidities complicating heart failure: changes over the last 15 years
Univ Groningen, Netherlands.
Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Univ Groningen, Netherlands.
Univ Groningen, Netherlands.
Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences.ORCID iD: 0000-0002-4197-4026
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2023 (English)In: Clinical Research in Cardiology, ISSN 1861-0684, E-ISSN 1861-0692, Vol. 112, no 1, p. 123-133Article in journal (Refereed) Published
Abstract [en]

Aims Management of comorbidities represents a critical step in optimal treatment of heart failure (HF) patients. However, minimal attention has been paid whether comorbidity burden and their prognostic value changes over time. Therefore, we examined the association between comorbidities and clinical outcomes in HF patients between 2002 and 2017. Methods and results The 2002-HF cohort consisted of patients from The Coordinating Study Evaluating Outcomes of Advising and Counseling in Heart Failure (COACH) trial (n = 1,032). The 2017-HF cohort were outpatient HF patients enrolled after hospitalization for HF in a tertiary referral academic hospital (n = 382). Kaplan meier and cox regression analyses were used to assess the association of comorbidities with HF hospitalization and all-cause mortality. Patients from the 2017-cohort were more likely to be classified as HF with preserved ejection fraction (24 vs 15%, p < 0.001), compared to patients from the 2002-cohort. Comorbidity burden was comparable between both cohorts (mean of 3.9 comorbidities per patient) and substantially increased with age. Higher comorbidity burden was significantly associated with a comparable increased risk for HF hospitalization and all-cause mortality (HR 1.12 [1.02-1.22] and HR 1.18 [1.05-1.32]), in the 2002- and 2017-cohort respectively. When assessing individual comorbidities, obesity yielded a statistically higher prognostic effect on outcome in the 2017-cohort compared to the 2002-HF cohort (p for interaction 0.026). Conclusion Despite major advances in HF treatment over the past decades, comorbidity burden remains high in HF and influences outcome to a large extent. Obesity emerges as a prominent comorbidity, and efforts should be made for prevention and treatment. [GRAPHICS] .

Place, publisher, year, edition, pages
Springer Heidelberg , 2023. Vol. 112, no 1, p. 123-133
Keywords [en]
Comorbidities; Heart failure; Hospitalization; Mortality; Obesity
National Category
Cardiology and Cardiovascular Disease
Identifiers
URN: urn:nbn:se:liu:diva-187859DOI: 10.1007/s00392-022-02076-1ISI: 000842585000003PubMedID: 35976430Scopus ID: 2-s2.0-85136144227OAI: oai:DiVA.org:liu-187859DiVA, id: diva2:1691672
Note

Funding Agencies|Dutch Heart Foundation [2017-21, 2017-11, 2018-30, 2020B005, 2000Z003, 03-005-2021-T005]; leDucq Foundation (Cure PhosphoLambaN induced Cardiomyopathy (Cure-PLaN)); European Research Council (SECRETE-HF) [ERC CoG 818715]; Mandema-Stipendium of the Junior Scientific Masterclass of the University Medical Center Groningen [202010]

Available from: 2022-08-30 Created: 2022-08-30 Last updated: 2025-02-10

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