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

Area of Science:

• Cardiology
• Clinical Research
• Epidemiology

Background:

• Heart failure (HF) is a complex syndrome with diverse etiologies.
• Understanding the prognostic implications of different HF causes is crucial for patient management.
• Long-term mortality outcomes vary significantly based on the underlying cause of heart failure.

Purpose of the Study:

• To compare long-term all-cause and cardiovascular (CV) mortality in heart failure outpatients across various etiologies.
• To identify specific HF etiologies associated with increased or decreased mortality risk.
• To establish ischemic heart disease (IHD) as a reference for comparing mortality risks.

Main Methods:

• Retrospective analysis of 2387 heart failure outpatients from August 2001 to September 2019.
• HF etiologies categorized into: IHD, dilated cardiomyopathy (DCM), hypertensive heart disease, alcoholic cardiomyopathy, drug-induced cardiomyopathy (DICM), valvular heart disease, and hypertrophic cardiomyopathy.
• Long-term all-cause and CV mortality assessed using survival analysis with IHD as the reference group.

Main Results:

• Dilated cardiomyopathy (DCM) was associated with a significantly lower risk of all-cause death (aHR 0.68).
• Drug-induced cardiomyopathy (DICM) showed a significantly higher risk of all-cause death (aHR 1.47).
• Most HF etiologies demonstrated a lower risk of CV death compared to IHD, which had the highest adjusted risk of CV death.

Conclusions:

• Dilated cardiomyopathy (DCM) and drug-induced cardiomyopathy (DICM) represent the lowest and highest risk groups for all-cause mortality in heart failure, respectively.
• Ischemic heart disease (IHD) carries the highest adjusted risk for cardiovascular death among the studied etiologies.
• Etiology-specific risk stratification is essential for optimizing management and improving outcomes in heart failure patients.