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Comorbidities and c...
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Savarese, GianluigiKarolinska Institutet
(author)
Comorbidities and cause-specific outcomes in heart failure across the ejection fraction spectrum : A blueprint for clinical trial design
- Article/chapterEnglish2020
Publisher, publication year, extent ...
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Elsevier BV,2020
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electronicrdacarrier
Numbers
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LIBRIS-ID:oai:DiVA.org:uu-423181
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-423181URI
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https://doi.org/10.1016/j.ijcard.2020.04.068DOI
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https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-170688URI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:144733375URI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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Funding Agencies|Boehringer IngelheimBoehringer Ingelheim; EU/EFPIA Innovative Medicines Initiative 2 Joint Undertaking BigData@ Heart grant [116074]
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BackgroundComorbidities may differently affect treatment response and cause-specific outcomes in heart failure (HF) with preserved (HFpEF) vs. mid-range/mildly-reduced (HFmrEF) vs. reduced (HFrEF) ejection fraction (EF), complicating trial design. In patients with HF, we performed a comprehensive analysis of type 2 diabetes (T2DM), atrial fibrillation (AF) chronic kidney disease (CKD), and cause-specific outcomes.Methods and resultsOf 42,583 patients from the Swedish HF registry (23% HFpEF, 21% HFmrEF, 56% HFrEF), 24% had T2DM, 51% CKD, 56% AF, and 8% all three comorbidities. HFpEF had higher prevalence of CKD and AF, HFmrEF had intermediate prevalence of AF, and prevalence of T2DM was similar across the EF spectrum. Patients with T2DM, AF and/or CKD were more likely to have also other comorbidities and more severe HF. Risk of cardiovascular (CV) events was highest in HFrEF vs. HFpEF and HFmrEF; non-CV risk was highest in HFpEF vs. HFmrEF vs. HFrEF. T2DM increased CV and non-CV events similarly but less so in HFpEF. CKD increased CV events somewhat more than non-CV events and less so in HFpEF. AF increased CV events considerably more than non-CV events and more so in HFpEF and HFmrEF.ConclusionHFpEF is distinguished from HFmrEF and HFrEF by more comorbidities, non-CV events, but lower effect of T2DM and CKD on events. CV events are most frequent in HFrEF. To enrich for CV vs. non-CV events, trialists should not exclude patients with lower EF, AF and/or CKD, who report higher CV risk.
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Settergren, CamillaKarolinska Institutet
(author)
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Schrage, BenediktKarolinska Institutet
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Thorvaldsen, TonjeKarolinska Institutet
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Löfman, IdaKarolinska Inst, Div Cardiol, Dept Med, SE-17176 Stockholm, Sweden
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Sartipy, UlrikKarolinska Institutet
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Mellbin, LindaKarolinska Institutet
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Meyers, AndreaBoehringer Ingelheim Pharmaceut, Ridgefield, CT USA
(author)
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Farsani, Soulmaz FazeliBoehringer Ingelheim Int GmbH, Ingelheim, Germany
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Brueckmann, MartinaBoehringer Ingelheim Int GmbH, Ingelheim, Germany; Heidelberg Univ, Fac Med Mannheim, Mannheim, Germany
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Brodovicz, Kimberly G.Boehringer Ingelheim Pharmaceut, Ridgefield, CT USA
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Vedin, OlaUppsala universitet,Kardiologi,Boehringer Ingelheim AB, Stockholm, Sweden,Boehringer Ingelheim AB, Sweden; Uppsala Univ, Sweden(Swepub:uu)olved933
(author)
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Asselbergs, Folkert W.Univ Utrecht, Univ Med Ctr Utrecht, Div Heart & Lungs, Dept Cardiol, Utrecht, Netherlands; UCL, Fac Populat Hlth Sci, Inst Cardiovasc Sci, London, England; UCL, Hlth Data Res UK, London, England; UCL, Inst Hlth Informat, London, England
(author)
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Dahlström, UlfLinköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US(Swepub:liu)ulfda85
(author)
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Cosentino, FrancescoKarolinska Institutet
(author)
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Lund, Lars H.Karolinska Institutet
(author)
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Karolinska InstitutetKarolinska Inst, Div Cardiol, Dept Med, SE-17176 Stockholm, Sweden
(creator_code:org_t)
Related titles
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In:International Journal of Cardiology: Elsevier BV313, s. 76-820167-52731874-1754
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