Association of Psychosocial Risk Factors and Outcomes in Heart Failure: Does COVID-19 Affect Outcomes?

Autor: Kasireddy TR; Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA., Yukselen Z; Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA; School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA., Muthyala A; Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA., Bansal K; Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA., Dasari M; Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA., Arun Kumar P; Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA., Anugu VR; John Ochsner Heart and Vascular Institute, Slidell, LA., Majmundar V; Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA., Nakhla M; Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA., Sharma G; Department of Cardiovascular Medicine, Inova Heart And Vascular Institute, Falls Church, VA., Nasir K; Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist, Houston, TX., Warraich HJ; Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA and Department of Medicine, VA Boston Healthcare System, Boston, MA., Ganatra S; Division of Cardiovascular Medicine, Department of Medicine, Lahey Hospital and Medical Center, Burlington, MA., Dani SS; Division of Cardiovascular Medicine, Department of Medicine, Lahey Hospital and Medical Center, Burlington, MA. Electronic address: Sourbha.s.dani@lahey.org.
Jazyk: angličtina
Zdroj: Current problems in cardiology [Curr Probl Cardiol] 2023 Oct; Vol. 48 (10), pp. 101795. Date of Electronic Publication: 2023 May 18.
DOI: 10.1016/j.cpcardiol.2023.101795
Abstrakt: Psychosocial risk factors (PSRFs) have emerged as crucial nontraditional risk factors affecting outcomes in patients with heart failure (HF). There is a paucity of data studying these risk factors in HF nationally. Additionally, whether the COVID-19 pandemic impacted outcomes remains unexplored, given the increased psychosocial risk during these times. Our objective is to assess the impact of PSRFs on the outcomes of HF and their comparison across non-COVID-19 and COVID-19 eras. Patients with a diagnosis of HF were selected using the 2019-2020 Nationwide Readmissions Database. Two cohorts were created based on the presence or absence of PSRFs and compared across non-COVID-19 and COVID-19 eras. We examined the association using hierarchical multivariable logistic regression models. A total of 305,955 patients were included, of which 175,348 (57%) had PSRFs. Patients with PSRFs were younger, less likely to be female, and had a higher prevalence of cardiovascular risk factors. All-cause readmissions were higher in patients with PSRFs in both the eras. All-cause mortality [odds ratio, OR 1.15 (1.04-1.27), P = 0.005] and composite of MACE [OR 1.11 (1.06-1.16), P < 0.001] were higher in patients in the non-COVID-19 era. Compared to 2019, patients with PSRFs and HF in 2020 had significantly higher all-cause mortality [OR 1.13 (1.03-1.24), P = 0.009]; however, the composite of MACE was comparable [OR 1.04 (1.00-1.09), P = 0.03]. In conclusion, the presence of PSRFs in patients with HF is associated with a significant increase in all-cause readmissions in COVID-19 and non-COVID-19 eras. The worse outcomes evident in the COVID-19 era highlights the importance of multidisciplinary care in this vulnerable population.
Competing Interests: Declaration of Competing Interest None.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: