心力衰竭(HF)的早期阶段与住院风险增加和死亡率增加有关。然而,老年高危患者的进展过程以及非心血管合并症对不良事件的影响尚不清楚.
在一组老年患者(年龄≥60岁,有≥1个HF危险因素,且无已知或临床怀疑的HF)中,探讨HF早期阶段未来发生心血管事件(CV)和非CV事件的风险。
共有400名来自哥本哈根心力衰竭风险研究的患者(美国心脏协会HFA期:N=177;B期:N=150;C期:N=73)被确定并随访HF住院(HFH)的主要复合结局。缺血性心脏病(IHD),中风,和全因死亡,记录在丹麦全国登记册内。非CV住院是次要结果。绝对风险由Aalen-Johansen估计器计算。
中位随访时间为3.3年,事件总数为83,主要结局的3年风险(95%置信区间)为12.8%(7.8-17.9),A期患者为22.8%(16.1-29.6)和31.8%(21.0-42.6),B,C,分别。1.1%(0.0-2.7),3.4%(1.0-6.3)和10.0%(2.8-16.3)经历了HFH作为他们的第一个事件,而37.3%(30.2-44.4),49.7%(41.6-57.8)和54.8%(43.4-66.2)因非CV原因作为其第一事件而入院。
HFH的风险,IHD,中风和全因死亡随着HF阶段的严重程度而增加,10%的未确诊的HFC期患者在3年内因HF入院。然而,与经历HFH的风险相比,非CV住院的风险更大.
Early stages of heart failure (HF) are associated with an increased risk of hospitalization and increased mortality, however the course of progression and the impact of non-cardiovascular comorbidities on adverse events in elderly high-risk patients are unknown.
To examine the risk of future cardiovascular (CV) and non-CV events in early stages of HF in a cohort of elderly patients (age ≥ 60 with ≥ 1 risk factor for HF and without known or clinically suspected HF).
A total of 400 patients (American Heart Association HF stage A: N = 177; stage B: N = 150; stage C: N = 73) from the Copenhagen Heart Failure Risk Study were identified and followed for the main composite outcome of a HF hospitalization (HFH), ischemic heart disease (IHD), stroke, and all-cause death, recorded within the Danish nationwide registries. Non-CV hospitalization was a secondary outcome. Absolute risk was calculated by the Aalen-Johansen estimator.
The median follow-up time was 3.3 years, total number of events were 83, and the 3-year risk (95% confidence interval) of the main outcome was 12.8% (7.8-17.9), 22.8% (16.1-29.6) and 31.8% (21.0-42.6) for patients with stage A, B, and C, respectively. 1.1% (0.0-2.7), 3.4% (1.0-6.3) and 10.0% (2.8-16.3) experienced HFH as their first event, whereas 37.3% (30.2-44.4), 49.7% (41.6-57.8) and 54.8% (43.4-66.2) were admitted for non-CV causes as their first event.
The risk of HFH, IHD, stroke and all-cause death increased with severity of HF stage, and 10% of patients with undiagnosed HF stage C were admitted for HF within 3 years. However, the risk of non-CV hospitalizations was greater compared to the risk of experiencing HFH.