Cause of Death in Heart Failure Based on Etiology: Long-Term Cohort Study of All-Cause and Cardiovascular Mortality

We assessed differences in long-term all-cause and cardiovascular (CV) mortality in heart failure (HF) outpatients based on the etiology of HF. Consecutive patients admitted to the HF Clinic from August 2001 to September 2019 ( = 2587) were considered for inclusion. HF etiology was divided into isch...

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Published in:Journal of clinical medicine 2022-01, Vol.11 (3), p.784
Main Authors: Spitaleri, Giosafat, Zamora, Elisabet, Cediel, German, Codina, Pau, Santiago-Vacas, Evelyn, Domingo, Mar, Lupón, Josep, Santesmases, Javier, Diez-Quevedo, Crisanto, Troya, Maria Isabel, Boldo, Maria, Altimir, Salvador, Alonso, Núria, González, Beatriz, Bayes-Genis, Antoni
Format: Article
Language:English
Subjects:
Cardiology
Cardiomyopathy
Cardiovascular disease
Clinical medicine
Cohort analysis
Coronary vessels
Emergency medical care
Etiology
Family physicians
Heart attacks
Heart failure
Hospitals
Hypertension
Medical imaging
Medical prognosis
Medical referrals
Mortality
Variance analysis
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Summary:We assessed differences in long-term all-cause and cardiovascular (CV) mortality in heart failure (HF) outpatients based on the etiology of HF. Consecutive patients admitted to the HF Clinic from August 2001 to September 2019 ( = 2587) were considered for inclusion. HF etiology was divided into ischemic heart disease (IHD), dilated cardiomyopathy (DCM), hypertensive heart disease, alcoholic cardiomyopathy, drug-induced cardiomyopathy (DICM), valvular heart disease, and hypertrophic cardiomyopathy. All-cause death and CV death were the primary end points. Among 2387 patients included in the analysis (mean age 66.5 ± 12.5 years, 71.3% men), 1317 deaths were recorded (731 from CV cause) over a maximum follow-up of 18 years (median 4.1 years, interquartile range (IQR) 2-7.8). Considering IHD as the reference, only DCM had a lower risk of all-cause death (adjusted hazard ratio (aHR) 0.68, 95% confidence interval (CI) 0.56-0.83, < 0.001), and only DICM had a higher risk of all-cause death (aHR 1.47, 95% CI 1.02-2.11, = 0.04). However, almost all etiologies had a significantly lower risk of CV death than IHD. Among the studied HF etiologies, DCM and DICM have the lowest and highest risk of all-cause death, respectively, whereas IHD has the highest adjusted risk of CV death.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm11030784