Heart failure & cardiomyopathies
Association of Charlson Comorbidity Index with Clinical Characteristics and Outcomes in Heart Failure
Authors' conclusion
The ACCI discriminates well in HF, with higher ACCI being associated with greater severity of HF, lesser GDMT use and worse quality of life. Higher ACCI was more strongly associated with death than hospitalization. Higher ACCI was more strongly associated with non-CV outcomes but also with CV and HF outcomes.
Study context
- Population
- Patients with heart failure in the Swedish heart failure (HF) registry
- Participants
- 117,419 patients
- Exposure
- Intermediate and high vs low ACCI
- Outcome
- Composite CV mortality/first HF hospitalization
- Follow-up
- Up to 3 years
Methodological detailsSwedish HF registry, multivariable multinominal and Cox regressions
- Swedish HF registry
- Multivariable multinominal and Cox regressions
Main finding
As reported in the abstract
Each group vs low ACCIAdjusted hazard ratio (95% CI)
Intermediate ACCI
1.34(1.29–1.39)
High ACCI
1.76(1.69–1.83)
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | |
|---|---|---|
| Non-CV mortalityHigh ACCIvs low ACCI | adjusted HR 6.36 (95% CI 5.75–7.04) | |
| CV mortalityHigh ACCIvs low ACCI | HR 4.35 (CI 3.99–4.74) | |
| Total hospitalizationsHigh ACCIvs low ACCI | adjusted IRR 2.16 (CI 2.11–2.22) | |
| 0.10.31310Ratio (log scale) |
| Outcome | Estimate |
|---|---|
| HF hospitalizationsHigh ACCI vs low ACCI | 1.23 (CI 1.17–1.28) |
Median ACCI by ejection fraction (EF) category
- Median ACCI in HFrEF (53% of patients)
- 5
- Median ACCI in HFmrEF (24% of patients)
- 6
- Median ACCI in HFpEF (23% of patients)
- 6
- ACCI ≥7 in HFrEF
- 31%
- ACCI ≥7 in HFmrEF
- 35%
- ACCI ≥7 in HFpEF
- 42%
Clinical characteristics and guideline-directed medical therapy (GDMT) use
- Higher ACCI associated with higher EF category, NYHA class, serum NT-proBNP, diuretic use, and lower quality of life and GDMT use
- P < 0.05 for all
Original publication
Association of Charlson Comorbidity Index with Clinical Characteristics and Outcomes in Heart Failure. ESC Heart Fail. Published 19 July 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →