RESEARCH ARTICLE


Five-Year Outcomes of Heart Failure with Preserved Ejection Fraction



Cristina Macía-Rodríguez1, *, Emilio Páez-Guillán2, Vanesa Alende-Castro3, Alba García-Villafranca1, Lara Maria Mateo-Mosquera2, Lucía Martínez-Braña4, María de los Ángeles Valcárcel García5, Francisco Luis Lado Lado2
1 Department of Internal Medicine, POVISA Hospital, Rúa Salamanca 5, Vigo, Pontevedra, Spain
2 Department of Internal Medicine, Complexo Hospitalario Universitario de Santiago de Compostela, Travesia da Choupana s/n, Santiago de Compostela, A Coruña, Spain
3 Department of Internal Medicine, Hospital do Salnés, Rúa Hospital do Salnes, 30, 36619 Vilagarcía de Arousa, Pontevedra, Spain
4 Department of Internal Medicine, Barbanza Hospital, Lugar Salmón s/n, Ribeira, ACoruña, Spain
5 Department of Internal Medicine, Costa Hospital, Rafael Vior s/n, Burela, Lugo, Spain


© 2020 Macía-Rodríguez et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Internal Medicine, POVISA Hospital, Rúa Salamanca, 5, Vigo, Pontevedra, Spain 32611; Tel: 0034639830796; E-mail: cristina.macia.rodriguez@gmail.com


Abstract

Objective:

The aim of this study was to describe the clinical characteristics of patients that have had a heart failure with preserved ejection fraction (HF-pEF) and to identify the factors associated with 5-year mortality and readmission.

Methods:

A prospective cohort study was conducted of patients followed by the Heart Failure Unit of the Internal Medicine Department. Clinical characteristics and outcomes were collected. Univariate and multivariate analyses were performed in order to identify factors associated with 5-year mortality and readmission.

Results:

A total of 209 patients with HF-pEF were followed, 59.3% of these were women, with a mean age 79 years. The main etiology was hypertensive heart disease and a high level of comorbidity (chronic renal failure, hypertension and atrial fibrillation) was observed. The 5-year mortality was 55.5%; the related variables were anemia (hazard ratio [HR]=1.7; 95% confidence interval [CI]: 1.2-2.5), in patients being treated with statins (HR=0.7; 95%CI 0.5-0.9) and spironolactone (HR= 1.6; 95% CI: 1.1-2.3); 24.5% of patients had >2 admission in 5 years, with the main related factors being atrial fibrillation (HR=2.7; 95%CI: 1.4-5.5), anemia (HR=1.9; 95%CI:1.0-3.3) and were being treated with spironolactone (HR=2.1; 95%CI:1.2-3.7).

Conclusion:

Patients with HF-pEF are old and present a high level of comorbidity. Furthermore, they have a high 5-year mortality and readmission rate. The only factor associated with lower mortality was the treatment with statins. The use of spironolactone was associated with a higher mortality risk.

Keywords: Heart failure, Diastolic heart failure, Preserved ejection fraction, Prognosis, mortality, Hospital readmission.