Estimated Glomerular Filtration Rate Is Associated With an Increased Risk of Death in Heart Failure Patients With Preserved Ejection Fraction.

Renal dysfunction is associated with adverse cardiovascular outcomes in patients with heart failure (HF), but its impact on patients with heart failure with preserved ejection fraction (HFpEF) remains unclear. 3,392 subjects of the TOPCAT (Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist) trial were assigned to two groups by estimated glomerular filtration rate (eGFR) ≥ 60 ml/min/1.73 m or 30-59 ml/min/1.73 m. The outcomes, including all-cause death, cardiovascular death and HF hospitalization, were examined by multivariable cox models. Over a median follow-up of 3.4 ± 1.7 years, a total of 524 all-cause deaths, 334 cardiovascular deaths and 440 HF hospitalizations occurred. Compared with patients with eGFR ≥ 60 ml/min/1.73 m, those with eGFR 30-59 ml/min/1.73 m were associated with an increased risk of the all-cause death [adjusted hazard ratio (HR), 1.47; 95% confidence interval (CI), 1.24-1.76; < 0.001], cardiovascular death (adjusted HR, 1.53; 95% CI: 1.23-1.91; < 0.001), and HF hospitalization (adjusted HR: 1.21; 95% CI: 1.00-1.47; = 0.049) after multivariable adjustment for potential confounders. eGFR 30-59 ml/min/1.73 m was related to an increased risk of all-cause death, cardiovascular death and HF hospitalization in HFpEF patients.