Heart failure & cardiomyopathiesCohort study
The Role of Multimorbidity in Patients with Heart Failure Across the Left Ventricular Ejection Fraction Spectrum: Data from the Swedish Heart Failure Registry
- Registry-based cohort study
- Swedish heart failure (HF) Registry
Authors' conclusion
The burden of both CV and non-CV comorbidities was high in HF regardless of EF, but overall higher in HFpEF. Multimorbidity was associated with a high risk of death with a different burden on CV or non-CV outcomes.
Study context
- Population
- Patients with HF across the ejection fraction (EF) spectrum, Swedish HF Registry, 2000–2021median age 76 years
- Participants
- 91,463 patients
- Outcome
- Overall comorbidity burden (CV and non-CV) across EF
Main finding
As reported in the abstract
Comorbidity burden (17 explored comorbidities)
≥1 comorbidity
98%
≥1 cardiovascular (CV) comorbidity
94%
≥1 non-CV comorbidity
85%
Observational data: associations, not effects.
Further findings
All-cause death by comorbidity (multivariable Cox)
| Comparison | HR (95% CI) | |
|---|---|---|
| Dementia | 1.55 (1.45–1.65) | |
| Chronic kidney disease | 1.37 (1.34–1.41) | |
| Chronic obstructive pulmonary disease | 1.32 (1.28–1.35) | |
| Obesity · lower risk | 0.81 (0.79–0.84) | |
| 0.512Hazard ratio (log scale) |
All-cause death by comorbidity (multivariable Cox)
- 12 comorbidities independently associated with higher risk of all-cause death
Cause-specific mortality by comorbidity
- Coronary artery disease (CAD) and valvular heart disease associated with higher all-cause and CV mortality, not non-CV mortality
- Cancer and musculo-skeletal disease increased risk of non-CV mortality
- Significant interaction with EF for several comorbidities
- CV and non-CV outcomes related to number of CV and non-CV comorbidities, respectively
Original publication
The Role of Multimorbidity in Patients with Heart Failure Across the Left Ventricular Ejection Fraction Spectrum: Data from the Swedish Heart Failure Registry. Eur J Heart Fail. Published 8 January 2024. doi:10.1002/ejhf.3112
Summarised from the published abstract; every number is checked against it