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Updated: Sep 1, 2025
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Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
Published on: June 10, 2025
203
Comorbidities complicating heart failure: changes over the last 15 years
Elles M Screever1, Martje H L van der Wal1,2, Dirk J van Veldhuisen1
1Department of Cardiology, Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, PO Box 30.001, 9700 RB, Groningen, the Netherlands.
Summary
Heart failure (HF) patients face a high comorbidity burden that significantly impacts outcomes. Obesity, in particular, shows an increased prognostic effect over time, necessitating focused prevention and treatment strategies.
Area of Science:
- Cardiology
- Internal Medicine
- Public Health
Background:
- Comorbidity management is crucial for optimal heart failure (HF) treatment.
- The evolution of comorbidity burden and its prognostic significance in HF patients over time remains understudied.
Purpose of the Study:
- To investigate the association between comorbidities and clinical outcomes in heart failure patients between 2002 and 2017.
- To assess changes in the prognostic value of comorbidities over this period.
Main Methods:
- Comparison of two cohorts: 2002-HF (COACH trial, n=1,032) and 2017-HF (outpatient HF patients, n=382).
- Utilized Kaplan-Meier and Cox regression analyses to evaluate the impact of comorbidities on HF hospitalization and all-cause mortality.
- Assessed individual comorbidity effects and interactions over time.
Main Results:
- The 2017 cohort showed a higher prevalence of HF with preserved ejection fraction compared to the 2002 cohort.
- Comorbidity burden was similar between cohorts (mean 3.9 comorbidities/patient) and increased with age.
- Higher comorbidity burden was significantly associated with increased risk of HF hospitalization and all-cause mortality in both cohorts.
- Obesity demonstrated a statistically significant higher prognostic effect on outcomes in the 2017 cohort compared to the 2002 cohort (p=0.026).
Conclusions:
- Despite advances in HF treatment, comorbidity burden remains substantial and significantly influences patient outcomes.
- Obesity has emerged as a prominent comorbidity with a growing impact on HF prognosis.
- Emphasizes the need for targeted prevention and management strategies for obesity in heart failure patients.
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