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Published on: October 1, 2019

Cardio-kidney-metabolic overlap in patients with severe heart failure: Data from the HELP-HF registry

Alessandro Villaschi1, Daniela Pini2, Davide Stolfo3

  • 1De Gasperis Cardio Center, ASST GOM Niguarda, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Pieve, Emanuele-Milan, Italy.

American Heart Journal
|June 4, 2026
PubMed

Insights

Cardiovascular, kidney, and metabolic (CKM) conditions are common in severe heart failure (HF). More CKM conditions significantly increase the risk of death and hospitalization in these patients.

Area of Science:

  • Cardiology
  • Nephrology
  • Endocrinology
  • Public Health

Background:

  • Cardiovascular, kidney, and metabolic (CKM) conditions frequently coexist in patients with heart failure (HF).
  • The prevalence and prognostic impact of CKM overlap in severe HF are underexplored.
  • Understanding CKM comorbidity is crucial for managing high-risk HF patients.

Purpose of the Study:

  • To evaluate the impact of CKM overlap in patients with severe heart failure (HF).
  • To determine the association between the number of CKM conditions and clinical outcomes.
  • To highlight the significance of CKM profiling in severe HF risk stratification.

Main Methods:

  • Analysis of 1149 patients from the multicenter HELP-HF registry with severe HF.
  • CKM conditions assessed: atherosclerotic cardiovascular disease (ASCVD), chronic kidney disease (CKD), and metabolic disorders.
  • Primary endpoint: composite of 1-year all-cause death or HF hospitalization; secondary endpoints: mortality and HF hospitalization.

Main Results:

  • CKM conditions are highly prevalent in severe HF (85.5% had at least one; 22.3% had all three).
  • ASCVD (58.7%), CKD (56.5%), and metabolic disorders (48.9%) were common.
  • Each additional CKM condition significantly increased the risk of death or HF hospitalization (e.g., 3 CKM conditions: HR 2.52).

Conclusions:

  • CKM overlap is highly prevalent in severe HF patients.
  • CKM comorbidity is independently associated with worse clinical outcomes, including mortality and hospitalization.
  • Comprehensive CKM profiling is essential for accurate risk stratification and management of severe HF.
Abstract

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