Heart failure & cardiomyopathies
Antecedent Kidney Function and Cardiovascular Mortality in Over 300 000 Patients With Incident Heart Failure With Preserved Ejection Fraction
Authors' conclusion
In this nationwide study of patients with incident HFpEF, antecedent kidney dysfunction was common but not uniformly present before HFpEF onset. Furthermore, among patients who developed HFpEF, antecedent kidney dysfunction identified a higher-risk phenotype, with progressively greater cardiovascular mortality and heart failure hospitalization with declining kidney function.
Study context
- Population
- Patients with incident heart failure with preserved ejection fraction (HFpEF) diagnosed between January 1, 2000, and June 30, 2025, at US Veterans Affairs hospitalsfinal cohort, of 304,712 patients meeting HFpEF ascertainment criteria
- Participants
- 236,910 patients
- Exposure
- Antecedent kidney function, including albuminuria, and its associations with 5-year cardiovascular death and heart failure hospitalization
- Outcome
- Cardiovascular death and heart failure hospitalization
- Follow-up
- 5-year
Methodological details170 US Veterans Affairs hospitals, nationwide, competing-risk analysis accounting for noncardiovascular death as a competing event for cardiovascular death
- 170 US Veterans Affairs hospitals
- Nationwide
- Competing-risk analysis accounting for noncardiovascular death as a competing event for cardiovascular death
Main finding
As reported in the abstract
- Progressively lower antecedent kidney function was associated with graded increases in cardiovascular death and heart failure hospitalization
Observational data: associations, not effects.
Further findings
Proportion of deaths attributed to cardiovascular causes, among decedents
P < 0.001
Antecedent estimated glomerular filtration rate (eGFR) distribution
- Antecedent eGFR ≥60 mL/min per 1.73m 2
- 51%
- eGFR ≥90 mL/min per 1.73m 2, overall
- 15%
Characteristics of patients with eGFR <60 mL/min per 1.73m 2
- Body mass index <30 kg/m 2, of the patients with eGFR <60 mL/min per 1.73m 2
- 51%
- Body mass index <25 kg/m 2, of the patients with eGFR <60 mL/min per 1.73m 2
- 20%
- Patients with eGFR <60 mL/min per 1.73m 2 were older and had more diabetes and hypertension
Original publication
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