Factors Associated with Outcome in Heart Failure with Preserved Ejection Fraction: Findings from the Irbesartan in Heart Failure with Preserved Ejection Fraction Study (I-PRESERVE)

Komajda, M., Carson, P. E., Hetzel, S., McKelvie, R., McMurray, J. , Ptaszynska, A., Zile, M. R., DeMets, D. and Massie, B. M. (2010) Factors Associated with Outcome in Heart Failure with Preserved Ejection Fraction: Findings from the Irbesartan in Heart Failure with Preserved Ejection Fraction Study (I-PRESERVE). Circulation: Heart Failure, 4(1), pp. 27-35. (doi:10.1161/CIRCHEARTFAILURE.109.932996)

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Publisher's URL: http://dx.doi.org/10.1161/CIRCHEARTFAILURE.109.932996

Abstract

Background: The determinants of prognosis in patients with heart failure and preserved ejection fraction (HF-PEF) are poorly documented. Methods and Results: We evaluated data from 4128 patients in the I-PRESERVE trial (Irbesartan in HF with Preserved Ejection Fraction Study). Multivariable Cox regression models were developed using 58 baseline demographic, clinical and biological variables to model the primary outcome of all cause mortality or cardiovascular hospitalization (1505 events), all cause mortality (881 events) and heart failure death or hospitalization (716 events). Log NT-proBNP, age, diabetes mellitus and previous hospitalization for heart failure were the most powerful factors associated with the primary outcome and with the heart failure composite. For all cause mortality, log NT-proBNP, age, diabetes mellitus and left ventricular ejection fraction were the strongest independent factors. Other independent factors associated with poor outcome included quality of life, ahistory of chronic obstructive lung disease, log neutrophil count, heart rate, and estimated glomerular filtration rate.The models accurately stratified actual 3 year rate of outcomes from 8.1% to 59.9% (primary outcome) 2.7% to 36.5% (all cause mortality) and 2.1% to 38.9% (HF composite) for the lowest to highest septiles of predicted risks. Conclusions: In a large sample of elderly patients with heart failure and preserved ejection fraction enrolled in I-Preserve, simple clinical, demographic and biological variables were associated with outcome and identified subgroups at very high and very low risk of events.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:McMurray, Professor John
Authors: Komajda, M., Carson, P. E., Hetzel, S., McKelvie, R., McMurray, J., Ptaszynska, A., Zile, M. R., DeMets, D., and Massie, B. M.
College/School:College of Medical Veterinary and Life Sciences
College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:Circulation: Heart Failure
Publisher:Lippincott Williams and Wilkins
ISSN:1941-3289
ISSN (Online):1941-3297
Published Online:10 November 2010

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