TY - JOUR

T1 - Association between early detected heart failure stages and future cardiovascular and non-cardiovascular events in the elderly (Copenhagen Heart Failure Risk Study)

AU - Parveen, Saaima

AU - Zareini, Bochra

AU - Arulmurugananthavadivel, Anojhaan

AU - Kistorp, Caroline

AU - Faber, Jens

AU - Køber, Lars

AU - Hassager, Christian

AU - Sørensen, Tor Biering

AU - Andersson, Charlotte

AU - Zahir, Deewa

AU - Iversen, Kasper

AU - Wolsk, Emil

AU - Gislason, Gunnar

AU - Gaborit, Freja

AU - Schou, Morten

N1 - Publisher Copyright: © 2022, The Author(s).

PY - 2022

Y1 - 2022

N2 - Background: Early stages of heart failure (HF) are associated with an increased risk of hospitalization and increased mortality, however the course of progression and the impact of non-cardiovascular comorbidities on adverse events in elderly high-risk patients are unknown. Aim: To examine the risk of future cardiovascular (CV) and non-CV events in early stages of HF in a cohort of elderly patients (age ≥ 60 with ≥ 1 risk factor for HF and without known or clinically suspected HF). Methods: A total of 400 patients (American Heart Association HF stage A: N = 177; stage B: N = 150; stage C: N = 73) from the Copenhagen Heart Failure Risk Study were identified and followed for the main composite outcome of a HF hospitalization (HFH), ischemic heart disease (IHD), stroke, and all-cause death, recorded within the Danish nationwide registries. Non-CV hospitalization was a secondary outcome. Absolute risk was calculated by the Aalen-Johansen estimator. Results: The median follow-up time was 3.3 years, total number of events were 83, and the 3-year risk (95% confidence interval) of the main outcome was 12.8% (7.8–17.9), 22.8% (16.1–29.6) and 31.8% (21.0–42.6) for patients with stage A, B, and C, respectively. 1.1% (0.0–2.7), 3.4% (1.0–6.3) and 10.0% (2.8–16.3) experienced HFH as their first event, whereas 37.3% (30.2–44.4), 49.7% (41.6–57.8) and 54.8% (43.4–66.2) were admitted for non-CV causes as their first event. Conclusion: The risk of HFH, IHD, stroke and all-cause death increased with severity of HF stage, and 10% of patients with undiagnosed HF stage C were admitted for HF within 3 years. However, the risk of non-CV hospitalizations was greater compared to the risk of experiencing HFH.

AB - Background: Early stages of heart failure (HF) are associated with an increased risk of hospitalization and increased mortality, however the course of progression and the impact of non-cardiovascular comorbidities on adverse events in elderly high-risk patients are unknown. Aim: To examine the risk of future cardiovascular (CV) and non-CV events in early stages of HF in a cohort of elderly patients (age ≥ 60 with ≥ 1 risk factor for HF and without known or clinically suspected HF). Methods: A total of 400 patients (American Heart Association HF stage A: N = 177; stage B: N = 150; stage C: N = 73) from the Copenhagen Heart Failure Risk Study were identified and followed for the main composite outcome of a HF hospitalization (HFH), ischemic heart disease (IHD), stroke, and all-cause death, recorded within the Danish nationwide registries. Non-CV hospitalization was a secondary outcome. Absolute risk was calculated by the Aalen-Johansen estimator. Results: The median follow-up time was 3.3 years, total number of events were 83, and the 3-year risk (95% confidence interval) of the main outcome was 12.8% (7.8–17.9), 22.8% (16.1–29.6) and 31.8% (21.0–42.6) for patients with stage A, B, and C, respectively. 1.1% (0.0–2.7), 3.4% (1.0–6.3) and 10.0% (2.8–16.3) experienced HFH as their first event, whereas 37.3% (30.2–44.4), 49.7% (41.6–57.8) and 54.8% (43.4–66.2) were admitted for non-CV causes as their first event. Conclusion: The risk of HFH, IHD, stroke and all-cause death increased with severity of HF stage, and 10% of patients with undiagnosed HF stage C were admitted for HF within 3 years. However, the risk of non-CV hospitalizations was greater compared to the risk of experiencing HFH.

KW - All-cause mortality

KW - Comorbidity

KW - Heart failure

KW - Heart failure stages

KW - Population attributable risk

U2 - 10.1186/s12877-022-02875-1

DO - 10.1186/s12877-022-02875-1

M3 - Journal article

C2 - 35313808

AN - SCOPUS:85126739577

VL - 22

JO - B M C Geriatrics

JF - B M C Geriatrics

SN - 1471-2318

M1 - 230

ER -