DOI: 10.1161/circ.148.suppl_1.12341 ISSN: 0009-7322

Abstract 12341: Cardiometabolic Comorbidity Burden and Risk of Hospitalization in Heart Failure Patients

Carine Hamo, Xiyue Li, Chiadi E Ndumele, Amrita Mukhopadhyay, Samrachana Adhikari, Saul Blecker
  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine

Background: Cardiometabolic comorbidities, obesity, diabetes, and hypertension, are highly prevalent in heart failure (HF). However, the implications of comorbidity burden on all-cause hospitalization, overall and among HF with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF), are unknown.

Hypothesis: Higher cardiometabolic burden is associated with increased hospitalization in individuals with HF.

Methods: In a retrospective EHR-based cohort of adults 18 with HF, we categorized individuals based on the number of cardiometabolic comorbidities present prior to 10/1/2021. Specifically, we defined presence of hypertension and/or diabetes mellitus by diagnosis code, and obesity by BMI 30kg/m2. Cox regression models were used to assess the association between number of cardiometabolic comorbidities and time to all-cause hospitalization within 1 year, adjusting for age, sex, race, and insurance status. Separate analyses were also conducted for HFpEF and HFrEF subgroups.

Results: There were 26,800 individuals with HF in the study population (mean age 75 13.7, 46% female, 69% White) who experienced 4,284 (16%) hospitalizations over a 1-year period. Compared to those with absent comorbidities (n=3,420), there was an increase in risk for all-cause hospitalization with increasing number of comorbidities, with adjusted hazard ratio (HR) 1.19 (95% CI 1.05-1.34) for 1 comorbidity (n=7,988), HR 1.25 (95% CI 1.11-1.41) for 2 comorbidities (n=9,553), and HR 1.43 (95% CI 1.26-1.62) for 3 comorbidities (n=5,839). ( Figure ) A similar association was also seen for the HFpEF subgroup, but not for the HFrEF subgroup.

Conclusions: Greater number of cardiometabolic comorbidities (hypertension, diabetes, and obesity) was associated with increased risk of all-cause hospitalization in HF, especially among patients with HFpEF. This suggests a possible role for targeting cardiometabolic comorbidities to reduce HF morbidity in HFpEF.

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