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Risk of de-novo heart failure and competing risk in asymptomatic patients with structural heart diseases

Tsuyoshi Takada1, Yasuhiko Sakata2, Kotaro Nochioka2

  • 1Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.

International Journal of Cardiology
|February 29, 2020
PubMed

Insights

Stage B patients with structural heart disease face high risks of developing new heart failure (HF) and death from various causes. Multidisciplinary management addressing cardiac and non-cardiac factors is crucial for prevention.

Area of Science:

  • Cardiology
  • Heart Failure Research
  • Clinical Trials

Background:

  • Asymptomatic patients with structural heart disease (Stage B) are at high risk for heart failure (HF).
  • Limited data exist on the incidence and contributing factors of de-novo heart failure (DNHF) in this population, considering competing risks.

Purpose of the Study:

  • To examine the incidence of death and DNHF in Stage B patients.
  • To identify factors associated with DNHF in this high-risk group.

Main Methods:

  • Analysis of 3362 Stage B patients from the CHART-2 Study.
  • Examination of incidence of death and DNHF (first HF hospitalization or HF death) over a median 6.0-year follow-up.
  • Application of competing risk and Bayesian structural equation modeling.

Main Results:

  • High incidence of DNHF (15/1000 person-years) and death (31/1000 person-years) observed.
  • Cardiovascular and non-cardiovascular deaths were significant competing risks.
  • Age, diabetes mellitus, stroke, atrial fibrillation, diastolic blood pressure, hemoglobin, eGFR, and LVEF were associated with DNHF.

Conclusions:

  • Stage B patients exhibit high rates of DNHF and all-cause mortality.
  • Management requires integrated approaches considering both cardiac and non-cardiac factors to prevent DNHF and competing non-HF deaths.
Abstract

Keywords:
Heart failurePreventionRisk factor

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