Renal function and long-term survival after hospital discharge in heart failure with preserved ejection fraction
| Autor: | D. Houpe, Dan Rusinaru, Christophe Tribouilloy, Otilia Buiciuc |
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| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty Heart disease Hemodynamics Renal function Kaplan-Meier Estimate Risk Factors Internal medicine medicine Hospital discharge Humans Prospective Studies Renal Insufficiency Chronic Aged Heart Failure Ejection fraction business.industry Stroke Volume Atrial fibrillation Middle Aged medicine.disease Patient Discharge Heart failure Cardiology Female Cardiology and Cardiovascular Medicine Heart failure with preserved ejection fraction business Follow-Up Studies Glomerular Filtration Rate |
| Zdroj: | International Journal of Cardiology. 147:278-282 |
| ISSN: | 0167-5273 |
| DOI: | 10.1016/j.ijcard.2009.09.529 |
| Popis: | Baseline renal function and worsening of renal function (WRF) during hospitalization for heart failure (HF) have a major prognostic impact in patients with left ventricular systolic dysfunction.We sought to prospectively investigate the impact of reduced baseline renal function and WRF during hospitalization on the 7-year outcome in 358 patients surviving a first admission to hospital for heart failure with preserved (≥ 50%) ejection fraction (HFPEF).Mean baseline estimated glomerular filtration rate (eGFR) was 59.4 ± 23.6 ml/min/1.73 m². Low admission eGFR (60 ml/min/1.73 m²) was frequently observed (190 patients--53% of the study population). Low baseline eGFR was associated with an increased risk of 7-year overall mortality (unadjusted hazard ratio [HR] 1.43[1.10-1.86]; p = 0.007) and cardiovascular mortality (unadjusted HR 1.57[1.13-2.19]; p = 0.007). After adjustment for covariates, the relationships remained significant. During hospitalization, WRF occurred in 43 patients (12%). History of renal failure, baseline systolic blood pressure160 mm Hg, and baseline atrial fibrillation were independent predictors of the development of WRF during hospitalization. WRF was independently predictive of 7-year overall mortality (adjusted HR 2.10[1.24-3.58]; p = 0.006) and cardiovascular mortality (adjusted HR 2.54[1.35-4.78]; p = 0.004) in patients with low baseline eGFR but not in those with baseline eGFR ≥ 60 ml/min/1.73 m².In patients admitted for the first time for HFPEF, low baseline eGFR is a potent predictor of long-term mortality. Patients with impaired renal function at baseline who develop WRF during hospitalization have particularly poor prognosis. |
| Databáze: | OpenAIRE |
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