Effect of severity and etiology of chronic kidney disease in patients with heart failure with mildly reduced ejection fraction.

IF 3.8 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Clinical Research in Cardiology Pub Date : 2024-11-01 Epub Date: 2024-05-06 DOI:10.1007/s00392-024-02453-y

Tobias Schupp, Kathrin Weidner, Felix Lau, Jan Forner, Alexander Schmitt, Marielen Reinhardt, Noah Abel, Niklas Ayasse, Thomas Bertsch, Muharrem Akin, Christel Weiß, Ibrahim Akin, Michael Behnes

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Abstract

Objective: The study investigates the prognostic impact of the severity and etiology of chronic kidney disease (CKD) in patients with heart failure with mildly reduced ejection fraction (HFmrEF).

Background: Data regarding the outcomes in patients with CKD in HFmrEF is scarce.

Methods: Consecutive patients with HFmrEF were retrospectively included at one institution from 2016 to 2022. Prognosis of patients with different stages and etiologies of CKD was investigated with regard to the primary endpoint of all-cause mortality at 30 months.

Results: A total of 2155 consecutive patients with HFmrEF were included with an overall prevalence of CKD of 31%. Even milder stages of CKD (i.e., KDIGO stage 3a) were associated with an increased risk of 30-months all-cause mortality (HR = 1.242; 95% CI 1.147-1.346; p = 0.001). However, long-term prognosis did not differ in patients with KDIGO stage 5 compared to patients with stage 4 (HR = 0.886; 95% CI 0.616-1.275; p = 0.515). Furthermore, the highest risk of HF-related rehospitalization was observed in patients with KDIGO stages 3b and 4 (log rank p ≤ 0.015), whereas patients with KDIGO stage 5 had a lower risk of HF-related rehospitalization compared to patients with KDIGO stage 4 (HR = 0.440; 95% CI 0.228-0.849; p = 0.014). In contrast, the etiology of CKD was not associated with the risk of 30-month all-cause mortality (log rank p ≥ 0.347) and HF-related rehospitalization (log rank p ≥ 0.149).

Conclusion: In patients with HFmrEF, even milder stages of CKD were independently associated with increased risk of 30-months all-cause mortality.

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射血分数轻度降低的心力衰竭患者慢性肾病严重程度和病因的影响。

研究目的该研究探讨了慢性肾脏疾病（CKD）的严重程度和病因对射血分数轻度降低型心力衰竭（HFmrEF）患者预后的影响：背景：有关射血分数轻度降低型心力衰竭（HFmrEF）慢性肾脏病患者预后的数据很少：方法：回顾性纳入一家机构2016年至2022年连续收治的HFmrEF患者。调查了不同阶段和病因的 CKD 患者在 30 个月内的主要终点（全因死亡率）的预后情况：结果：共纳入了2155名连续的HFmrEF患者，CKD总患病率为31%。即使是较轻的 CKD 阶段（即 KDIGO 3a 阶段）也与 30 个月全因死亡风险增加有关（HR = 1.242；95% CI 1.147-1.346；p = 0.001）。然而，KDIGO 5 期患者的长期预后与 4 期患者相比并无差异（HR = 0.886；95% CI 0.616-1.275；P = 0.515）。此外，KDIGO 3b 期和 4 期患者的 HF 相关再住院风险最高（对数秩 p ≤ 0.015），而与 KDIGO 4 期患者相比，KDIGO 5 期患者的 HF 相关再住院风险较低（HR = 0.440；95% CI 0.228-0.849；p = 0.014）。相比之下，CKD病因与30个月全因死亡风险（对数秩p≥0.347）和HF相关再住院风险（对数秩p≥0.149）无关：结论：在高频低氧血症患者中，即使是较轻的慢性肾脏病分期也与30个月全因死亡风险的增加有独立相关性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Research in Cardiology 医学-心血管系统

CiteScore

11.40

自引率

4.00%

发文量

140

审稿时长

4-8 weeks

期刊介绍： Clinical Research in Cardiology is an international journal for clinical cardiovascular research. It provides a forum for original and review articles as well as critical perspective articles. Articles are only accepted if they meet stringent scientific standards and have undergone peer review. The journal regularly receives articles from the field of clinical cardiology, angiology, as well as heart and vascular surgery. As the official journal of the German Cardiac Society, it gives a current and competent survey on the diagnosis and therapy of heart and vascular diseases.