Campbell-Quintero Sebastián, Echeverría Luis Eduardo, Gómez-Mesa Juan Esteban, Rivera-Toquica Alex, Rentería-Asprilla Carlos Alberto, López-Garzón Nelson Adolfo, Alcalá-Hernández Armando Enrique, Accini-Mendoza José Luis, Baquero-Lozano Gary Andrés, Martínez-Carvajal Argemiro Ramon, Cadena Alberto, Zarama-Márquez Mario Hernán, Ramírez-Puentes Elkin Giovanni, Bustamante Rafael Ignacio, Saldarriaga Clara
Cardiology Department, Clínica Medilaser, Florencia, Colombia.
Cardiology Department, Fundación Cardiovascular de Colombia, Floridablanca, Colombia.
Int J Cardiol. 2023 May 1;378:123-129. doi: 10.1016/j.ijcard.2023.02.020. Epub 2023 Feb 13.
Heart failure (HF) is usually accompanied by cardiovascular and non-cardiovascular comorbidities, which may significantly impact its prognosis. In this study we aimed to characterize the comorbidity profile and its impact in mortality in patients with HF diagnosis from the Colombian Heart Failure Registry (RECOLFACA).
RECOLFACA enrolled adult patients with HF diagnosis from 60 centers in Colombia during the period 2017-2019. The primary outcome was all-cause mortality. A Cox proportional hazards regression model was used to assess the impact of the comorbidities in mortality. A p-value of <0.05 was considered significant.
From the total 2528 patients included in the registry, 2514 patients (58% males, mean age 68 years) had information regarding comorbidity diagnoses. 2321 patients (92.3%) reported at least one comorbidity. Arterial hypertension was the most frequent individual diagnosis (72%; n = 1811), followed by anemia (30.1%, n = 726). The most frequently observed coexisting comorbidities were coronary disease (CHD) with dyslipidemia, and chronic kidney disease (CKD) with type 2 Diabetes Mellitus (T2DM). Different patterns of comorbidity coexistence were observed when comparing HF patients by sex and left-ventricular ejection fraction (LVEF) classification. The only comorbidities that were significantly associated with mortality after multivariate adjustment were T2DM (HR 1.45. 95% CI 1.01-2.12), anemia (HR 1.48. 95% CI 1.02-2.16), and CHD (HR 1.59. 95% CI 1.09-2.33).
Multiple comorbidities were frequently observed in the patients from the RECOLFACA. T2DM, anemia and CHD were significantly associated with a higher risk of mortality, highlighting the importance of promoting an optimal follow-up and control of these conditions.
心力衰竭（HF）通常伴有心血管和非心血管合并症，这可能会显著影响其预后。在本研究中，我们旨在描述合并症概况及其对哥伦比亚心力衰竭登记处（RECOLFACA）中诊断为HF的患者死亡率的影响。
RECOLFACA在2017年至2019年期间招募了来自哥伦比亚60个中心的成年HF诊断患者。主要结局是全因死亡率。使用Cox比例风险回归模型评估合并症对死亡率的影响。p值<0.05被认为具有统计学意义。
在登记的2528例患者中，2514例患者（58%为男性，平均年龄68岁）有合并症诊断信息。2321例患者（92.3%）报告至少有一种合并症。动脉高血压是最常见的单一诊断（72%；n = 1811），其次是贫血（30.1%；n = 726）。最常观察到的并存合并症是冠心病（CHD）合并血脂异常，以及慢性肾脏病（CKD）合并2型糖尿病（T2DM）。按性别和左心室射血分数（LVEF）分类比较HF患者时，观察到不同的合并症共存模式。多因素调整后，与死亡率显著相关的唯一合并症是T2DM（HR 1.45，95%CI 1.01 - 2.12）、贫血（HR 1.48，95%CI 1.02 - 2.16）和CHD（HR 1.59，95%CI 1.09 - 2.33）。
在RECOLFACA的患者中经常观察到多种合并症。T2DM、贫血和CHD与较高的死亡风险显著相关，突出了促进对这些疾病进行最佳随访和控制的重要性。
