Prognosticators of All-Cause Mortality in Patients With Heart Failure With Preserved Ejection Fraction.
Prognosticators of All-Cause Mortality in Patients With Heart Failure With Preserved Ejection Fraction.
复制标题
DOI：
10.1016/j.amjcard.2021.07.044
复制
发表时间：
2021-11-01
期刊：
影响因子：
--
通讯作者：
Zahid M
中科院分区：
文献类型：
--
作者：
Lopuszynski JB;Downing AJ;Finley CM;Zahid M
射血分数正常的心力衰竭（HFpEF）约占所有充血性心力衰竭（CHF）病例的50%，预计患病率将随着人群老龄化而增加。我们对2014年1月至2017年1月期间在Excela医疗保健系统的3家医院住院的主要诊断为HFpEF心力衰竭加重的所有患者进行了一项观察性研究。收集了最接近索引住院的人口统计学数据、实验室检查结果和超声心动图。487例患者入院时的主要诊断为CHF加重和HFpEF，平均年龄为80.5岁（±10.9），62%为女性，主要为白人（98.8%）。在平均21.7个月的随访中，246名患者死亡，全因死亡率为51.3%。生成多个连续变量的受试者操作曲线，以确定最佳截止值，然后生成Kaplan-Meir生存曲线。临床因素通过单变量考克斯回归模型进行检验，显著因素进入逐步多变量模型。我们的模型确定年龄> 80岁，血清白蛋白水平<3.2gm/dl，N末端脑钠肽前体（NT-proBNP）> 5000 pg/ml和中位E/e '≥ 20是全因死亡率的显著独立预测因素（p值<0.0001）。令人惊讶的是，缺乏高血压的诊断与死亡风险显著增加有关。在以社区为基础的HFpEF患者样本中，我们确定了多个因素，这些因素是全因死亡率的强有力的独立预测因素，可以很容易地应用于临床环境。
Heart failure with preserved ejection fraction (HFpEF) represents ~50% of all cases of congestive heart failure (CHF) with prevalence expected to increase with aging of the population. We performed an observational study of all patients admitted to 3 hospitals in the ExcelaHealth care system with a primary diagnosis of HFpEF heart failure exacerbation between January 2014 and January 2017. Demographic data, laboratory results and echocardiograms performed closest to index hospitalization were collected. 487 patients were admitted with a primary diagnosis of CHF exacerbation and HFpEF, with a mean age of 80.5 years (±10.9), 62% women and predominantly Caucasian (98.8%). Over a median follow-up of 21.7 months, 246 patients died with an all-cause mortality rate of 51.3%. Receiver operator curves were generated for multiple continuous variables to identify optimal cut-off values Kaplan-Meir survival curves were then generated. Clinical factors were tested by univariate Cox regression modelling, with significant factors entered into a step-wise multivariate model. Our modeling identified age>80yrs, serum albumin level<3.2gm/dl, N-terminal pro-brain natriuretic peptide (NT-proBNP)>5000pg/ml and medial E/e’≥20 as significant, independent predictors of all-cause mortality (p-value<0.0001). Surprisingly, lack of a diagnosis of hypertension was associated with significantly increased mortality risk. In a community-based sample of HFpEF patients, we identified multiple factors that were strong, independent predictors of all-cause mortality, that can be easily applied in a clinical setting.
登录
查看更多内容
影响因子：
4.1
作者：
Pacho C;Domingo M;Núñez R;Lupón J;Núñez J;Barallat J;Moliner P;de Antonio M;Santesmases J;Cediel G;Roura S;Pastor MC;Tor J;Bayes-Genis A
通讯作者：
Bayes-Genis A
影响因子：
2.8
作者：
Prenner, Stuart B.;Kumar, Anupam;Chirinos, Julio A.
通讯作者：
Chirinos, Julio A.
影响因子：
1.5
作者：
Wang, Conglin;Zhou, Yan;Tian, Jianli
通讯作者：
Tian, Jianli
影响因子：
6.2
作者：
Park, Jae-Hyeong;Hwang, In-Chang;Cho, Goo-Yeong
通讯作者：
Cho, Goo-Yeong
DOI：
10.1161/hhf.0b013e318291329a
发表时间：
2013-05
期刊：
Circulation. Heart failure
影响因子：
--
作者：
Heidenreich PA;Albert NM;Allen LA;Bluemke DA;Butler J;Fonarow GC;Ikonomidis JS;Khavjou O;Konstam MA;Maddox TM;Nichol G;Pham M;Piña IL;Trogdon JG;American Heart Association Advocacy Coordinating Committee;Council on Arteriosclerosis, Thrombosis and Vascular Biology;Council on Cardiovascular Radiology and Intervention;Council on Clinical Cardiology;Council on Epidemiology and Prevention;Stroke Council
通讯作者：
Stroke Council