Key result
An eGFR of 30-59 ml/min/1.73 m2 was associated with an increased risk of all-cause death compared to eGFR ≥60 ml/min/1.73 m2 in patients with HFpEF (HR 1.47; 95% CI 1.24-1.76; P<0.001).
Why the study?
Renal dysfunction is linked to adverse cardiovascular outcomes in heart failure, but its impact on patients with HFpEF remains unclear.
Does moderate renal dysfunction (eGFR 30-59 ml/min/1.73 m2) increase the risk of death and heart failure hospitalization in patients with HFpEF compared to eGFR ≥ 60 ml/min/1.73 m2?
Cohort (n=3,392)
Does moderate renal dysfunction (eGFR 30-59 ml/min/1.73 m2) increase the risk of death and heart failure hospitalization in patients with HFpEF compared to eGFR ≥ 60 ml/min/1.73 m2?
Hazard Ratio: 1.47 (95% CI 1.24–1.76)
p-value: p=<0.001
In patients with HFpEF, moderate renal dysfunction (eGFR 30-59 ml/min/1.73 m2) is independently associated with a significantly increased risk of all-cause mortality, cardiovascular mortality, and heart failure hospitalization.
Moderate renal dysfunction flags higher-risk HFpEF for monitoring; extends observational data but leaves causal impact on outcomes open.
Background: Renal dysfunction is associated with adverse cardiovascular outcomes in patients with heart failure (HF), but its impact on patients with heart failure with preserved ejection fraction (HFpEF) remains unclear. Methods: 3,392 subjects of the TOPCAT (Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist) trial were assigned to two groups by estimated glomerular filtration rate (eGFR) ≥ 60 ml/min/1.73 m 2 or 30–59 ml/min/1.73 m 2 . The outcomes, including all-cause death, cardiovascular death and HF hospitalization, were examined by multivariable cox models. Results: Over a median follow-up of 3.4 ± 1.7 years, a total of 524 all-cause deaths, 334 cardiovascular deaths and 440 HF hospitalizations occurred. Compared with patients with eGFR ≥ 60 ml/min/1.73 m 2 , those with eGFR 30–59 ml/min/1.73 m 2 were associated with an increased risk of the all-cause death [adjusted hazard ratio (HR), 1.47; 95% confidence interval (CI), 1.24–1.76; P < 0.001], cardiovascular death (adjusted HR, 1.53; 95% CI: 1.23–1.91; p < 0.001), and HF hospitalization (adjusted HR: 1.21; 95% CI: 1.00–1.47; p = 0.049) after multivariable adjustment for potential confounders. Conclusions: eGFR 30–59 ml/min/1.73 m 2 was related to an increased risk of all-cause death, cardiovascular death and HF hospitalization in HFpEF patients.
No takes yet. Share an insight, caveat, or question.
Chen et al. (2021) conducted a cohort in Heart failure with preserved ejection fraction (HFpEF) (n=3,392). eGFR 30–59 ml/min/1.73 m2 vs. eGFR ≥ 60 ml/min/1.73 m2 was evaluated on all-cause death (HR 1.47, 95% CI 1.24-1.76, p=<0.001). An eGFR of 30-59 ml/min/1.73 m2 was associated with an increased risk of all-cause death compared to eGFR ≥60 ml/min/1.73 m2 in patients with HFpEF (HR 1.47; 95% CI 1.24-1.76; P<0.001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: