Incidence and predictors of mortality in a contemporary cohort of patients with heart failure
J L Bonilla Palomas, A Esteban Fernandez, M Anguita Gamez, R Gonzalez Manzanares, J Muniz Garcia, S Mirabet Perez, A Cequier Fillat, L Rodriguez Padial, M Anguita SanchezAbstract
Introduction
Heart failure (HF) is currently a major public health problem because its high morbidity and mortality add to a high consumption of health resources. The study of predictors of mortality helps to identify patients for whom care should be intensified.
Purposes
In this study we aim to assess the incidence and predictors of mortality at one-year follow-up.
Methods
We conducted a prospective observational study. Patients were included from 67 HF units in Spain (from the registry of the SEC-Excelente-IC quality accreditation program of the Spanish Society of Cardiology). Patients were consecutively enrolled in two one-month cohorts (March and October) between 2019 and 2023. Demographic, clinical, laboratory, echocardiographic, and treatment variables were collected. To study the independent association of each variable with mortality a Cox multivariate regression model was performed.
Results
A total of 2245 patients were included (59.6% previous chronic HF, 40.4 de novo HF). Mean age was 71,05±12,28 years, 64.3% were male, the most frequent etiology was ischemic heart disease (31%), median left ventricular ejection fraction was 38% (interquartile range -IR-, 29%-54%), and median NTproBNP was 2000 (IR, 878-4612) pg/ml. 72.8% had arterial hypertension, 44.2% diabetes mellitus, 52.4% atrial fibrillation, 37.8% chronic kidney disease (CKD), 32.5% anemia, and 16.3% chronic obstructive pulmonary disease. At one-year of follow-up, mortality was 15,1%. Table 1 shows the variables independently associated with mortality.
Conclusions
At one year of follow-up, all-cause mortality was 15,1%. Ischemic etiology, previous admission for HF, a worse functional class and some comorbidities such atrial fibrillation, CKD, dementia, cancer, anemia or malnutrition are variables independently associated with mortality.