Impact of polyvascular disease severity on acute heart failure prognosis.

Autor: Gatuz MV; Department of Cardiology, Hillel Yaffe Medical Center, Hadera, Israel., Abu-Fanne R; Department of Cardiology, Hillel Yaffe Medical Center, Hadera, Israel., Abramov D; Department of Cardiology, Linda Loma University Health, Linda Loma, USA., Mamas MA; Keele Cardiovascular Research Group, Keele University, Keele, UK.; National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, Birmingham, UK., Roguin A; Department of Cardiology, Hillel Yaffe Medical Center, Hadera, Israel., Kobo O; Department of Cardiology, Hillel Yaffe Medical Center, Hadera, Israel. ofermkobo@gmail.com.; Keele Cardiovascular Research Group, Keele University, Keele, UK. ofermkobo@gmail.com.
Jazyk: angličtina
Zdroj: Heart and vessels [Heart Vessels] 2024 Dec 01. Date of Electronic Publication: 2024 Dec 01.
DOI: 10.1007/s00380-024-02496-1
Abstrakt: Polyvascular disease, is a prevalent comorbidity among patients with acute heart failure (AHF). Previous research has shown that polyvascular disease is a poor prognostic factor in patients with heart failure. However, data on the relationship between the extent of vascular disease involvement and outcomes in AHF patients are limited. Using the National Inpatient Sample from 2016 to 2019, adult patients with AHF were stratified by number of diseased vascular beds and into heart failure with reduced ejection fraction (HFrEF) and with preserved ejection fraction (HFpEF). The study assessed in-hospital major adverse cardiovascular and cerebrovascular events (MACCE), mortality, cerebrovascular accident (CVA), and major bleeding. Multivariable regression models examined the association between outcomes and number of diseased vascular beds. This analysis included 652,710 patients hospitalized with AHF, of which 42.2% had disease of 1 vascular site and 57.8% had polyvascular disease. As the number of involved vascular beds increased, AHF patients tended to be older and with higher comorbidity burden. The mean length of stay and total hospital charge increased with a greater number of diseased vascular beds (p < 0.001). Moreover, the adjusted odds of MACCE, all-cause mortality, CVA, and major bleeding showed a significant increase with a greater number of diseased vascular beds (p trend < 0.001) with similar trends for patients with HFrEF and HFpEF. The extent of polyvascular disease involvement is associated with higher in-hospital adverse event rates in AHF patients. These findings highlight the importance of comprehensive vascular assessment and targeted interventions to improve outcomes in this high-risk population.
Competing Interests: Declarations. Conflict of interest: None.
(© 2024. Springer Nature Japan KK, part of Springer Nature.)
Databáze: MEDLINE
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