Heart failure & cardiomyopathiesCohort study
Frailty According to the 2019 Heart Failure Association of the European Society of Cardiology (HFA-ESC) Definition in Patients at Risk for Advanced Heart Failure: Insights from the HELP-HF Registry
- Registry-based cohort study
Authors' conclusion
Frailty in patients at risk for advanced HF, assessed via a multi-domain approach and the FI, is highly prevalent and identifies those at increased risk of adverse events. The FI was found to be slightly more effective in identifying patients at increased risk of mortality.
Study context
- Population
- Patients at risk for advanced heart failure (HF), HELP-HF registry
- Participants
- 854 patients
- Exposure
- Number of HFA-ESC frailty domains fulfilled and frailty index (FI) quintiles
- Zero domainsn = 37reference
- One domainn = 206
- Two domainsn = 365
- Three domainsn = 217
- Four domainsn = 29
- Outcome
- All-cause death or HF hospitalization
- Follow-up
- 1 year
Main finding
As reported in the abstract
All-cause death or HF hospitalisation, per HFA-ESC frailty domain fulfilled
Hazard ratio
1.43
95% CI 1.27–1.62
Each criterion increase
HR 1.43 (95% CI 1.27–1.62)
Each criterion increase, as printed
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| All-cause death, HF hospitalisation and CV death, per HFA-ESC frailty domain fulfilled · 1 year — Each criterion increase · all-cause death | 1.72 (1.46–2.02) | |
| All-cause death, HF hospitalisation and CV death, per HFA-ESC frailty domain fulfilled · 1 year — Each criterion increase · CV death | 1.77 (1.45–2.15) | |
| 0.512Hazard ratio (log scale) |
| Outcome | subHR (95% CI) |
|---|---|
| All-cause death, HF hospitalisation and CV death, per HFA-ESC frailty domain fulfilled · 1 year — Each criterion increase · HF hospitalisations | 1.21 (1.04–1.31) |
Outcomes by FI quintiles
- Consistent results stratifying the cohort for FI quintiles
Discriminative ability: FI (continuous) vs number of domains fulfilled
- AUC, FI vs number of domains
- 0.68 vs. 0.64, p = 0.004
Original publication
Frailty According to the 2019 HFA-ESC Definition in Patients at Risk for Advanced Heart Failure: Insights from the HELP-HF Registry. Eur J Heart Fail. Published 14 May 2024. doi:10.1002/ejhf.3234
Summarised from the published abstract; every number is checked against it