Cause of Death in Heart Failure Based on Etiology : Long-Term Cohort Study of All-Cause and Cardiovascular Mortality

Giosafat Spitaleri, Elisabet Zamora, Germán Cediel, Pau Codina, Evelyn Santiago Vacas, Mar Domingo, Josep Lupón, Javier Santesmases, Crisanto Diez-Quevedo, Maria Isabel Troya, Maria Boldo Alcaine, Salvador Altimir Losada, Núria Alonso Pedrol, Beatriz González Fernández, Antoni Bayés-Genís

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We assessed differences in long-term all-cause and cardiovascular (CV) mortality in heart failure (HF) outpatients based on the etiology of HF. Consecutive patients admitted to the HF Clinic from August 2001 to September 2019 (N = 2587) were considered for inclusion. HF etiology was divided into ischemic heart disease (IHD), dilated cardiomyopathy (DCM), hypertensive heart disease, alcoholic cardiomyopathy, drug-induced cardiomyopathy (DICM), valvular heart disease, and hypertrophic cardiomyopathy. All-cause death and CV death were the primary end points. Among 2387 patients included in the analysis (mean age 66.5 ± 12.5 years, 71.3% men), 1317 deaths were recorded (731 from CV cause) over a maximum follow-up of 18 years (median 4.1 years, interquartile range (IQR) 2-7.8). Considering IHD as the reference, only DCM had a lower risk of all-cause death (adjusted hazard ratio (aHR) 0.68, 95% confidence interval (CI) 0.56-0.83, p < 0.001), and only DICM had a higher risk of all-cause death (aHR 1.47, 95% CI 1.02-2.11, p = 0.04). However, almost all etiologies had a significantly lower risk of CV death than IHD. Among the studied HF etiologies, DCM and DICM have the lowest and highest risk of all-cause death, respectively, whereas IHD has the highest adjusted risk of CV death.
Idioma originalEnglish
RevistaJournal of Clinical Medicine
Estat de la publicacióPublicada - 2022


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