Risk Factors and Outcomes Associated With Heart Failure With Preserved and Reduced Ejection Fraction in People With Chronic Kidney Disease.
| Autor: | Bansal N; Division of Nephrology, University of Washington, Seattle (N.B., L.Z.)., Zelnick LR; Division of Nephrology, University of Washington, Seattle (N.B., L.Z.)., Scherzer R; Kidney Health Research Collaborative, University of California, San Francisco (R.S., M.E., M.S.)., Estrella M; Kidney Health Research Collaborative, University of California, San Francisco (R.S., M.E., M.S.)., Shlipak MG; Kidney Health Research Collaborative, University of California, San Francisco (R.S., M.E., M.S.). |
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| Jazyk: | angličtina |
| Zdroj: | Circulation. Heart failure [Circ Heart Fail] 2024 May; Vol. 17 (5), pp. e011173. Date of Electronic Publication: 2024 May 14. |
| DOI: | 10.1161/CIRCHEARTFAILURE.123.011173 |
| Abstrakt: | Background: Heart failure (HF) is associated with poor outcomes in people with chronic kidney disease, yet it is unknown whether outcomes differ by HF subtype. This study aimed to examine associations of incident HF with preserved ejection fraction (HFpEF) versus HF with reduced ejection fraction (HFrEF) with progression to end-stage kidney disease (ESKD) and mortality. Methods: We studied individuals with chronic kidney disease in the CRIC study (Chronic Renal Insufficiency Cohort) who were free of HF at cohort entry. Incident HF hospitalizations were adjudicated and classified into HFpEF (ejection fraction, ≥50%) or HFrEF (ejection fraction, <50%) based on echocardiograms performed during the hospitalization or at a research study visit. ESKD was defined as need for chronic dialysis or kidney transplant. Cox proportional hazards were used to evaluate the association of time-updated HF subtype with risk of ESKD and mortality, adjusting for demographics, comorbidities, and medication use. Results: Among the 3557 study participants without HF at cohort entry, mean age was 57 years and mean estimated glomerular filtration rate was 45 mL/min per 1.73 m 2 . A total of 682 participants had incident HF. Incidence rates for HFpEF and HFrEF were 0.9 (95% CI, 0.8-1.0) and 0.7 (95% CI, 0.6-0.8) per 100 person-years, respectively ( P Conclusions: In a chronic kidney disease population, the rates of HFpEF hospitalizations were greater than that of HFrEF. Risk of ESKD was high but not statically different across HF subtypes. There was a stronger association of HFrEF with mortality. Prevention and treatment of both HFpEF and HFrEF should be central priorities to improve outcomes in chronic kidney disease. Competing Interests: Disclosures None. |
| Databáze: | MEDLINE |
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