Abstract 14780: Characterization of HFrEF and HFpEF According to Three Categories of Risk Factors: Modifiable, Non-Modifiable, and the Social Determinants

Background: The prevalence of HF is expected to rise in the next decade. In this cross-sectional study, we aim to explore HF according to three categories of risk factors involved in its development: modifiable, non-modifiable, and social determinants.

Methods: We conducted a cross-sectional study using the National Inpatient Sample(NIS) Database. The variables in NIS were defined using the ICD-10-CM. The study population was from 2016 to 2020, aged 18 years and above. We included patients admitted to the hospital with a principal diagnosis of HFrEF or HFpEF. Exclusion criteria included patients with isolated right heart failure and uncategorized HF. We analyzed the hospital location and baseline patient characteristics, including, race, age, income, smoking, alcohol and drug abuse, and comorbidities. The primary outcome was inpatient mortality. The data were analyzed with STATA software.

Results: A total of 951,714 patients were included; 502,490 had HFrEF and 449,225 HFpEF with a mean age of 67.4 and 74.4 respectively. The HFrEF group had more men (63%) and the HFpEF group had more women (62%) (A). Patients in the 1 ^st income (lowest) quartile constituted the largest proportion of HFrEF and HFpEF compared to the other quartiles (B). We noted a statistically higher proportion of patients with HFrEF compared to HFpEF in the 1st income quartile (35 vs. 29% respectively). In the 4th quartile, HFpEF was more common than HFrEF (20 vs. 17% respectively ) (B). HTN (64%), DM (41%), renal failure (39%), and COPD (41%) were the most common comorbidities in both groups. Smoking, alcohol abuse, and drug use were more frequent in patients with HFrEF than HFpEF being 20 vs. 11%, 6 vs. 3%, and 8 vs. 2% respectively. Mortality was 3% in HFrEF and 2% in HFpEF (p <0.0001).

Conclusion: This analysis presents data that emphasizes the importance of all three categories of risk factors, including the social determinants. It could help to develop effective interventions to reduce the future burden of HF.