Key result
A high allostatic load was significantly associated with a more than four-fold increased risk of all-cause mortality (HR 4.21) compared to a low allostatic load in older men with heart failure with preserved ejection fraction.
Why the study?
No studies had focused on the association between allostatic load and the prognosis of patients with HFpEF.
Does higher allostatic load increase the risk of adverse outcomes in elderly male patients with HFpEF?
Cohort (n=1,111)
No
Does higher allostatic load increase the risk of adverse outcomes in elderly male patients with HFpEF?
Hazard Ratio: 4.21 (95% CI 2.27–7.83)
Absolute Event Rate: 59.09% vs 6.31%
A higher allostatic load is independently associated with increased risks of all-cause mortality, cardiovascular mortality, non-cardiovascular mortality, and heart failure admission in elderly male patients with HFpEF.
Higher AL identifies high-risk elderly male HFpEF patients; hypothesis-generating and requires prospective validation before clinical adoption.
BACKGROUND: The allostatic load (AL) refers to the cumulative weakening of multiple physiological systems caused by repeated adaptation of the body to stressors There are still no studies have focused on the association between AL and the prognosis of patients with heart failure with preserved ejection fraction (HFpEF). The present study aimed to investigate the association between AL and adverse outcomes, including mortality and HF admission, among elderly male patients with HFpEF. METHODS: We conducted a prospective cohort study of 1111 elderly male patients with HFpEF, diagnosed between 2015 and 2019 and followed up through 2021. We constructed an AL measure using a combination of 12 biomarkers. The diagnosis of HFpEF was made according to the 2021 European Society of Cardiology guidelines. A Cox proportional hazards model was used to determine the associations between AL and adverse outcomes. RESULTS: In multivariate analysis, AL was significantly associated with increased risk of all-cause mortality (medium AL: adjusted hazard ratio [HR] = 2.53; 95% confidence interval [CI] 1.37-4.68; high AL: HR = 4.21; 95% CI 2.27-7.83; per-score increase: HR = 1.31; 95% CI 1.18-1.46), cardiovascular mortality (medium AL: HR = 2.67; 95% CI 1.07-6.68; high AL: HR = 3.13; 95% CI 1.23-7.97; per-score increase: HR = 1.20; 95% CI 1.03-1.40), non-cardiovascular mortality (medium AL: HR = 2.45; 95% CI 1.06-5.63; high AL: HR = 5.81; 95% CI 2.55-10.28; per-score increase: HR = 1.46; 95% CI 1.26-1.69), and HF admission (medium AL: HR = 2.68; 95% CI 1.43-5.01; high AL: HR = 3.24; 95% CI 1.69-6.23; per-score increase: HR = 1.24; 95% CI 1.11-1.39). Consistent results were found in multiple subgroup analyses. CONCLUSIONS: A higher AL was associated with poor prognosis in elderly men with HFpEF. AL relies on information that is easily obtained in physical examinations and laboratory parameters and can be assessed in various care and clinical settings to help risk stratification of HFpEF patients.
No takes yet. Share an insight, caveat, or question.
Hao et al. (2023) conducted a cohort in Heart failure with preserved ejection fraction (HFpEF) (n=1,111). Allostatic load vs. Low allostatic load was evaluated on All-cause mortality (HR 4.21, 95% CI 2.27-7.83). A high allostatic load was significantly associated with a more than four-fold increased risk of all-cause mortality (HR 4.21) compared to a low allostatic load in older men with heart failure with preserved ejection fraction.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: