Chronic kidney disease independently predicted a six-month composite of all-cause mortality or heart failure rehospitalization (HR 2.192, p=0.030) in patients with hypertensive cardiomyopathy.
Cohort (n=90)
Does chronic kidney disease predict adverse outcomes in patients hospitalized for decompensated heart failure with hypertensive cardiomyopathy?
In patients hospitalized for decompensated heart failure with hypertensive cardiomyopathy, chronic kidney disease is a strong independent predictor of early adverse events and one-year mortality.
Hazard Ratio: 2.192
p-value: p=0.030
Objective: Hypertensive cardiomyopathy is a frequent pathway to heart failure with preserved ejection fraction and a major complication of long-standing uncontrolled hypertension. We assessed the prognostic contribution of cardiovascular risk factors and comorbidities in patients hospitalised for decompensated heart failure with hypertensive cardiomyopathy. Design and method: We performed a retrospective cohort study of 90 consecutive patients admitted with decompensated heart failure and a prior diagnosis of hypertensive cardiomyopathy, defined by heart failure with preserved ejection fraction, left ventricular hypertrophy, elevated natriuretic peptide level and a history of uncontrolled hypertension. The primary outcome was a six-month composite of all-cause mortality or rehospitalisation for heart failure. The secondary outcome was one-year all-cause mortality. Multivariable time-to-event analyses were performed using Cox proportional hazards models. Results: Participants were 61.1 per cent women (55 of 90) with a mean age of 78.5 years. Diabetes mellitus was present in 47.8 per cent (43 of 90) and dyslipidaemia in 41.1 per cent (37 of 90). Major comorbidities included atrial fibrillation (44.4 per cent; 40 of 90), coronary artery disease (24.4 per cent; 22 of 90), chronic kidney disease (14.4 per cent; 13 of 90) and prior cerebrovascular disease (8.9 per cent; 8 of 90). After adjustment for age, diabetes mellitus and atrial fibrillation, chronic kidney disease independently predicted the six-month composite outcome (hazard ratio 2.192, p value 0.030) and one-year all-cause mortality (hazard ratio 2.532, p value 0.030). Conclusions: In this real-world cohort hospitalised for decompensated heart failure with hypertensive cardiomyopathy, chronic kidney disease was the strongest prognostic marker for both early adverse events and one-year mortality. Systematic assessment of renal disease may improve post-discharge risk stratification and follow-up intensity. Larger prospective cohorts are needed to validate these findings and to test targeted cardio-renal management strategies.
Aguiar et al. (Fri,) conducted a cohort in decompensated heart failure with hypertensive cardiomyopathy (n=90). Chronic kidney disease was evaluated on six-month composite of all-cause mortality or rehospitalisation for heart failure (HR 2.192, p=0.030). Chronic kidney disease independently predicted a six-month composite of all-cause mortality or heart failure rehospitalization (HR 2.192, p=0.030) in patients with hypertensive cardiomyopathy.