Estimated Glomerular Filtration Rate Is Associated With an Increased Risk of Death in Heart Failure Patients With Preserved Ejection Fraction

Frontiers in Cardiovascular Medicine

article

Zhuo Chen¹  Qian Lin²  Jingen Li³  Xinyi Wang⁴  Jianqing Ju¹  Hao Xu¹  Dazhuo Shi¹ 

[1] Cardiovascular Diseases Center, National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences;Graduate School, China Academy of Chinese Medical Sciences;Department of Cardiology, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine;Graduate School, Beijing University of Chinese Medicine

关键词: heart failure;    preserved ejection fraction;    estimated glomerular filtration rate;    outcome;    risk of death;   

DOI  :  10.3389/fcvm.2021.643358

学科分类：地球科学(综合)

来源: Frontiers

【 摘 要 】

Background: Renal dysfunction is associated with adverse cardiovascular outcomes in patients with heart failure (HF), but its impact on patients with heart failure with preserved ejection fraction (HFpEF) remains unclear. Methods: 3,392 subjects of the TOPCAT (Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist) trial were assigned to two groups by estimated glomerular filtration rate (eGFR) ≥ 60 ml/min/1.73 m 2 or 30–59 ml/min/1.73 m 2 . The outcomes, including all-cause death, cardiovascular death and HF hospitalization, were examined by multivariable cox models. Results: Over a median follow-up of 3.4 ± 1.7 years, a total of 524 all-cause deaths, 334 cardiovascular deaths and 440 HF hospitalizations occurred. Compared with patients with eGFR ≥ 60 ml/min/1.73 m 2 , those with eGFR 30–59 ml/min/1.73 m 2 were associated with an increased risk of the all-cause death [adjusted hazard ratio (HR), 1.47; 95% confidence interval (CI), 1.24–1.76; P < 0.001], cardiovascular death (adjusted HR, 1.53; 95% CI: 1.23–1.91; p < 0.001), and HF hospitalization (adjusted HR: 1.21; 95% CI: 1.00–1.47; p = 0.049) after multivariable adjustment for potential confounders. Conclusions: eGFR 30–59 ml/min/1.73 m 2 was related to an increased risk of all-cause death, cardiovascular death and HF hospitalization in HFpEF patients.

【 授权许可】

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