January 1, 2013
Patterns of Comorbidity in Older Adults with Heart Failure: The Cardiovascular Research Network PRESERVE Study
Key Result
Older adults with heart failure with preserved ejection fraction had a slightly higher mean burden of comorbidities than those with reduced ejection fraction (4.5 vs 4.4 conditions, P=0.002).
Study Design
Type
Cross-Sectional (n=23,435)
Multicenter
Yes
Structured PICO
Does the total burden and pattern of comorbidity vary between older adults with heart failure with preserved versus reduced ejection fraction?
P
Population
23,435 adults aged 65 and older with heart failure (HF) based on hospital discharge and ambulatory visit diagnoses, including 12,407 (53%) with HF with preserved LVEF (HF-P, LVEF ≥50%; mean age 79.6, 60% female).
O
Outcome
Total burden of comorbidity and pattern of co-occurring conditions
Older adults with heart failure have a high burden of multiple comorbidities, which is slightly higher in those with preserved compared to reduced ejection fraction, though the patterns of co-occurrence are similar.
Main Result
Absolute Event Rate: 4.5% vs 4.4%
p-value: p=.002
Abstract
OBJECTIVES: To examine whether the total burden of comorbidity and pattern of co-occurring conditions varies in individuals with heart failure (HF) with preserved left ventricular ejection fraction (LVEF) (HF-P) or HF with reduced LVEF (HF-R). DESIGN: Cross-sectional cohort study. SETTING: Four participating health plans within the National Heart, Lung, and Blood Institute-sponsored Cardiovascular Research Network. PARTICIPANTS: All members aged 65 and older with HF based on hospital discharge and ambulatory visit diagnoses. MEASUREMENTS: Participants with a LVEF of 50% or greater were classified as having HF-P. Presence of cardiac and noncardiac comorbidities was obtained from health plan administrative databases. RESULTS: Of 23,435 individuals identified with HF and LVEF information, 53% (12,407) had confirmed HF-P (mean age 79.6; 60% female). More than three-quarters of the sample had three or more co-occurring conditions in addition to HF, and half had five or more cooccurring conditions. Participants with HF-P had a slightly higher burden of comorbidity than those with HF-R (mean 4.5 vs 4.4, P = .002). Patterns of how specific conditions co-occurred did not vary in participants with preserved or reduced systolic function. CONCLUSION: There is a high degree of comorbidity and multiple morbidity in individuals with HF. The burden and pattern of comorbidity varies only slightly in individuals with preserved or reduced LVEF.
Cite This Study
Saczynski et al. (Tue,) conducted a cross-sectional in Heart failure (n=23,435). Heart failure with preserved LVEF (HF-P) vs. Heart failure with reduced LVEF (HF-R) was evaluated on Total burden of comorbidity (mean number of co-occurring conditions) (p=.002). Older adults with heart failure with preserved ejection fraction had a slightly higher mean burden of comorbidities than those with reduced ejection fraction (4.5 vs 4.4 conditions, P=0.002).