Heart failure & cardiomyopathiesCohort study
Use of Medical Therapy and Risk of Clinical Events According to Frailty in Heart Failure Patients – A Real-Life Cohort Study
- Retrospective cohort study
- nationwide Danish registers
- multivariable-adjusted Cox models
Authors' conclusion
In real-world HF patients, frailty was associated with lower HF therapy use and with a higher incidence of clinical outcomes including mortality and non-HF hospitalization.
Study context
- Population
- Patients with new-onset heart failure (HF) across the entire range of EF, Denmark, 2014–2021mean age 69.1 years
- Participants
- 35,999 patients
- Exposure
- Moderate or severe frailty vs not frail
- Outcome
- Use of HF therapy and clinical outcomes (all-cause mortality, HF hospitalization, non-HF hospitalization)
Main finding
As reported in the abstract
HF therapy initiation by frailty status (reference: not frail)
- ACEi/ARB initiation, moderate frailty: HR
- 0.74 (95% confidence interval 0.70-0.77) (95% CI)
- ACEi/ARB initiation, severe frailty: HR
- 0.48 (0.43-0.53) (95% CI)
- Beta-blocker initiation, moderate frailty: HR
- 0.74 (0.71-0.78) (95% CI)
- Beta-blocker initiation, severe frailty: HR
- 0.51 (0.46-0.56) (95% CI)
- MRA initiation, moderate frailty: HR
- 0.83 (0.80-0.87) (95% CI)
- MRA initiation, severe frailty: HR
- 0.58 (0.53-0.64) (95% CI)
Observational data: associations, not effects.
Further findings
Clinical outcomes by frailty status (reference: not frail)
- Death, moderate frailty: HR
- 1.55 (1.47-1.63) (95% CI)
- Death, severe frailty: HR
- 2.32 (2.16-2.49) (95% CI)
- Non-HF hospitalization, moderate frailty: HR
- 1.37 (1.32-1.41) (95% CI)
- Non-HF hospitalization, severe frailty: HR
- 1.82 (1.72-1.92) (95% CI)
- HF hospitalization, moderate frailty: HR (95% CI) (association not significant, per authors)
- 1.08 [1.02-1.14]
- HF hospitalization, severe frailty: HR (95% CI) (association not significant)
- 1.08 [0.97-1.20]
- multivariable-adjusted Cox models
Original publication
Use of Medical Therapy and Risk of Clinical Events According to Frailty in Heart Failure Patients – A Real-Life Cohort Study. Eur J Heart Fail. Published 3 May 2024. doi:10.1002/ejhf.3249
Summarised from the published abstract; every number is checked against it