Heart failure & cardiomyopathies
Impact of Multimorbidity on Mortality in Heart Failure With Mildly Reduced and Preserved Ejection Fraction
Authors' conclusion
The risk associated with comorbidity pairs differs at the patient and population levels in heart failure with mildly reduced ejection fraction/heart failure with preserved ejection fraction. At the population level, hypertension, CKD, and diabetes account for the greatest risk, whereas at the patient level, polyvascular disease and chronic obstructive pulmonary disease are the most important.
Study context
- Population
- Patients with heart failure with mildly reduced ejection fraction/heart failure with preserved ejection fraction
- Participants
- 6,504 patients
- Comparison
- The 5 most common cardiovascular and noncardiovascular comorbidities and the resultant 45 comorbidity pairs
Methodological detailsCox proportional hazard models, population-attributable fractions, relative excess risk due to interaction
- Cox proportional hazard models
- Population-attributable fractions
- Relative excess risk due to interaction
Primary result
As reported in the abstract
At least 2 of the 10 most prevalent comorbidities
95.2%
Further findings
All-cause mortality, patient-level risk by comorbidity pair
- Stroke and peripheral artery disease, adjusted hazard ratio
- 1.88 [95% CI, 1.27-2.79]
- Peripheral artery disease and chronic obstructive pulmonary disease, adjusted hazard ratio
- 1.81 [95% CI, 1.31-2.51]
- Coronary artery disease and stroke, adjusted hazard ratio
- 1.67 [95% CI, 1.33-2.11]
All-cause mortality, population-level risk by comorbidity pair
- Hypertension and chronic kidney disease (CKD), adjusted population-attributable fraction
- 14.8% [95% CI, 9.2%-19.9%]
- Diabetes and CKD, adjusted population-attributable fraction
- 13.3% [95% CI, 10.6%-16.0%]
- Hypertension and diabetes, adjusted population-attributable fraction
- 11.9% [95% CI, 7.1%-16.5%
Synergistic interaction (more than additive risk)
- Stroke and coronary artery disease, relative excess risk due to interaction
- 0.61 [95% CI, 0.13-1.09]
- Diabetes and CKD, relative excess risk due to interaction
- 0.46 [95% CI, −0.15 to 0.77]
- Obesity and CKD, relative excess risk due to interaction
- 0.24 [95% CI, 0.01-0.46]
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →