Key result
Comorbid conditions including chronic lung disease, diabetes, renal dysfunction, and anemia frequently coexist with heart failure and adversely affect patient prognosis.
Heart failure patients with multiple comorbidities have worse prognoses, highlighting the need for their inclusion in future clinical trials.
Supports routine comorbidity evaluation in HF; leaves open optimal inclusion strategies for multimorbid patients in trials.
PURPOSE OF REVIEW: It is well known that patients with heart failure also suffer from a large number of comorbid conditions, which confound their heart failure management and adversely affect the prognosis. The purpose of this review is to evaluate the latest developments of these conditions. RECENT FINDINGS: Chronic lung disease commonly coexists with heart failure. It is more prevalent and worsens prognosis more in patients with preserved (heart failure with preserved ejection fraction) than with reduced ejection fraction (heart failure with reduced ejection fraction). Patients with diabetes have increased risk of incident heart failure, and as a comorbid condition it adversely affects prognosis. The relative impact on mortality and heart failure hospitalization remains controversial. Renal dysfunction is also common in patients with heart failure, with similar prevalence among those with preserved ejection fraction and those with reduced ejection fraction. The prognosis seems mainly related to long-term changes in kidney function, rather than to short-term changes in serum creatinine. Anemia and iron deficiency have a similar profile in terms of prevalence and impact on prognosis. Recent data suggest a benefit of intravenous iron infusion in patients who are iron deficient. SUMMARY: As patients with comorbid conditions are frequently excluded from clinical trials, future clinical trials should recruit these patients and include endpoints that will be reflective of these conditions.
No takes yet. Share an insight, caveat, or question.
Gordon W. Moe (2016) conducted a review in Heart failure with multiple comorbidities. Comorbid conditions including chronic lung disease, diabetes, renal dysfunction, and anemia frequently coexist with heart failure and adversely affect patient prognosis.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:
More on HFrEF treatmentMore from Current Opinion in Cardiology