Coexisting Morbidity Burden in Hospitalized Elderly Patients with New-Onset Heart Failure vs Acutely Decompensated Chronic Heart Failure. (July 2022)

• Record Type: Journal Article
• Authors: Xanthopoulos, Andrew; Tryposkiadis, Konstantinos; Giamouzis, Grigorios; Dimos, Apostolos; Bourazana, Angeliki; Papamichalis, Michail; Zagouras, Alexandros; Iakovis, Nikolaos; Kitai, Takeshi; Skoularigis, John; Starling, Randall C.; Triposkiadis, Filippos
• Is Part Of: Angiology. Volume 73:Number 6(2022)
• Page Start: 520
• Page End: 527
• Publication Date: 2022-07
• Subjects: comorbidities -- elderly -- hospitalized -- heart failure -- outcome; Blood-vessels -- Diseases -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; 616.13005
• DOI: 10.1177/00033197211062661
• Languages: English
• ISSNs: 0003-3197

Abstract

Coexisting morbidities (CM) are common in patients with heart failure (HF). This study evaluated the CM burden and its clinical significance in elderly hospitalized patients with new-onset (De-novo) HF (n = 84) and acutely decompensated chronic HF (ADCHF) (n = 122). All had HF symptoms associated with: (a) LVEF <50%, or, (b) left ventricular ejection fraction (LVEF) ≥50% and NT-proBNP ≥300 pg/mL. The primary endpoint was the composite of all-cause death/HF rehospitalization at 6 months. Age was similar between patients with new-onset HF and ADCHF [82 (12.5) vs 80 (11) years, respectively; P = .549]. The CM burden was high in both groups. However, the number of CM [3 (2) vs 4 (1.75)] and the prevalence of multimorbidity [CM ≥2; 65 (77.4%) vs 108 (88.5%)] were lower in new-onset HF ( P = .016 and P = .035, respectively). The survival probability without the primary endpoint was higher in new-onset HF than in ADCHF ( P = .001) driven by less rehospitalizations ( P = .001). In the total study population significant primary endpoint predictors were red blood cell distribution width (RDW), urea, and coronary artery disease (CAD) prevalence (AUC of the model =.7685), whereas significant death predictors were RDW, urea, and the number of CM (AUC = .7859), all higher in ADCHF. Thus, the higher CM burden in ADCHF than in new-onset HF most likely contributed to the worse outcome.