12-month mortality and hospitalizations in patients with heart failure with preserved ejection fraction and comorbid hypertension and type 2 diabetes mellitus
DOI:
https://doi.org/10.58354/jvc.107E.2023.703Từ khóa:
Heart Failure with Preserved Ejection Fraction, All-cause Mortality, All-cause Hospitalization, Hypertension, Type 2 Diabetes MellitusTóm tắt
Background: Heart failure with preserved ejection fraction (HFpEF) carries a high risk of mortality and hospitalization, especially in patients with comorbid hypertension and type 2 diabetes mellitus. Little is known about the prognosis of hypertensivediabetic HFpEF in Vietnam.
Objective: To examine the 12-month mortality, hospitalization, and combined outcome of all-cause mortality or heart failure hospitalization in hypertensivediabetic HFpEF patients.
Methods and Materials: A 12-month prospective cohort study conducted in University Medical Center, HCMC and Nhan Dan Gia Dinh hospital. Recruiting period started in January 2021 and ended in April 2022.
Results: 233 patients were recruited. During 12-month, 6.9% died (n=16), in which 50% were due to cardiovascular cause. Hospital admission was reported in 62.2% of patients (n=145). 23.5% (n =55) were hospitalized at least 3 times. During the first hospitalization, 57.3% were due to cardiovascular reasons, most often heart failure (24.2%) and acute myocardial infarction (9%). Among non-cardiovascular admissions (42.7%), infection was the leading cause (22.1%). Combined outcome was observed in 24.9% (n=58).
Conclusions: Hypertensivediabetic HFpEF patients experienced high rates of adverse events during a 12-month period, which were not restricted to cardiovascular causes, but also triggered by non-cardiovascular diseases. Comprehensive management should be taken into consideration to reduce both cardiovascular and noncardiovascular events.
Tài liệu tham khảo
Shah KS, Xu H, Matsouaka RA, et al. Heart Failure With Preserved, Borderline, and Reduced Ejection Fraction: 5-Year Outcomes. J Am Coll Cardiol. 2017;70(20):2476-2486. doi: 10.1016/j.jacc.2017.08.074.
Marx N, Federici M, Schütt K, et al. 2023 ESC Guidelines for the management of cardiovascular disease in patients with diabetes. Eur Heart J. 2023;44(39):4043-4140. doi: 10.1093/eurheartj/ehad192.
Canepa M, Kapelios CJ, Benson L, et al. Temporal Trends of Heart Failure Hospitalizations in Cardiology Versus Noncardiology Wards According to Ejection Fraction: 16-Year Data From the SwedeHF Registry. Circ Heart Fail. 2022;15(8):e009462. doi: 10.1161/CIRCHEARTFAILURE.121.009462.
Carson PE, Anand IS, Win S, et al. The Hospitalization Burden and Post-Hospitalization Mortality Risk in Heart Failure With Preserved Ejection Fraction: Results From the I-PRESERVE Trial (Irbesartan in Heart Failure and Preserved Ejection Fraction). JACC Heart Fail. 2015;3(6):429-441. doi: 10.1016/j.jchf.2014.12.017.
Yap J, Tay WT, Teng TK, et al. Association of Diabetes Mellitus on Cardiac Remodeling, Quality of Life, and Clinical Outcomes in Heart Failure With Reduced and Preserved Ejection Fraction. J Am Heart Assoc. 2019;8(17):e013114. doi: 10.1161/JAHA.119.013114.
Tay WT, Teng TK, Simon O, et al. Readmissions, Death and Its Associated Predictors in Heart Failure With Preserved Versus Reduced Ejection Fraction. J Am Heart Assoc. 2021;10(22):e021414. doi: 10.1161/JAHA.121.021414.
Cunningham JW, Vaduganathan M, Claggett BL, et al. Myocardial Infarction in Heart Failure With Preserved Ejection Fraction: Pooled Analysis of 3 Clinical Trials. JACC Heart Fail. 2020;8(8):618-626. doi: 10.1016/j.jchf.2020.02.007.
Savarese G, Settergren C, Schrage B, et al. Comorbidities and cause-specific outcomes in heart failure across the ejection fraction spectrum: A blueprint for clinical trial design. Int J Cardiol. 2020;313:76-82. doi: 10.1016/j.ijcard.2020.04.068.
Savarese G, Becher PM, Lund LH, et al. Global burden of heart failure: a comprehensive and updated review of epidemiology. Cardiovasc Res. 2023 Jan 18;118(17):3272-3287. doi: 10.1093/cvr/cvac013.
