一项关于充血性心力衰竭危险因素及预后的病例对照研究。
A Case-Control Study on Risk Factors and Outcomes in Congestive Heart Failure.
作者信息
Ahmad Mohammad Shakil, Alharbi Abdulrahman Obaid Matar, Tawakul Abdullah, Alturiqy Abdulrahman Mohammed, Alzahrani Mansour, Shaik Riyaz Ahamed
机构信息
Department of Family and Community Medicine, College of Medicine, Majmaah University, 11952 Majmaah, Saudi Arabia.
Department of Internal Medicine, College of Medicine, Majmaah University, 11952 Majmaah, Saudi Arabia.
出版信息
Rev Cardiovasc Med. 2025 Mar 24;26(3):26601. doi: 10.31083/RCM26601. eCollection 2025 Mar.
BACKGROUND
Congestive heart failure (CHF) represents an important health issue characterised by considerable morbidity and mortality. This study sought to identify risk factors for CHF and to evaluate clinical outcomes between CHF patients and control subjects.
METHODS
Data were obtained through interviews, physical examinations, and medical records. Risk variables encompassed hypertension, diabetes, dyslipidaemia, tobacco use, alcohol use, sedentary lifestyle, dietary practices, age, gender, and familial history of cardiovascular disease. The outcomes were all-cause mortality, cardiovascular mortality, hospitalisation, major adverse cardiovascular events (MACE), quality of life as measured by the Minnesota Living with Heart Failure Questionnaire (MLHFQ), and functional level according to the New York Heart Association (NYHA) classification. Statistical analyses including -tests, Chi-square tests, logistic regression and Cox regression.
RESULTS
The findings indicated that hypertension (71.8% vs. 38.5%, < 0.001), diabetes (47.9% vs. 28.2%, = 0.002), dyslipidaemia (54.7% vs. 41.0%, = 0.04), smoking (42.7% vs. 29.1%, = 0.03), and physical inactivity (65.8% vs. 41.9%, < 0.001) were more prevalent in cases. Cases exhibited increased hospitalisations (1.8 ± 1.2 vs. 0.7 ± 0.9, < 0.001), prolonged stays (10.5 ± 5.4 vs. 6.2 ± 3.8 days, < 0.001), elevated 30-day rehospitalisation rates (21.4% vs. 8.5%, = 0.007), and a greater incidence of intensive care units (ICU) admissions (17.1% vs. 6.0%, = 0.01). All-cause mortality (35.9% vs. 17.1%, = 0.001), cardiovascular mortality (25.6% vs. 10.3%, = 0.003), and MACE (51.3% vs. 25.6%, < 0.001) were greater in cases. Quality of life (45.8 ± 12.4 vs. 25.6 ± 10.3, < 0.001) and functional status (55.6% vs. 23.9%, < 0.001) were inferior in cases.
CONCLUSION
CHF patients had greater rates of modifiable risk variables and worse clinical outcomes than controls, underscoring the necessity for comprehensive risk management.
背景
充血性心力衰竭（CHF）是一个重要的健康问题，具有相当高的发病率和死亡率。本研究旨在确定CHF的危险因素，并评估CHF患者与对照受试者之间的临床结局。
方法
通过访谈、体格检查和病历获取数据。风险变量包括高血压、糖尿病、血脂异常、吸烟、饮酒、久坐的生活方式、饮食习惯、年龄、性别和心血管疾病家族史。结局指标为全因死亡率、心血管死亡率、住院率、主要不良心血管事件（MACE）、用明尼苏达心力衰竭生活问卷（MLHFQ）测量的生活质量以及根据纽约心脏协会（NYHA）分类的功能水平。统计分析包括t检验、卡方检验、逻辑回归和Cox回归。
结果
研究结果表明，高血压（71.8%对38.5%，P<0.001）、糖尿病（47.9%对28.2%，P = 0.002）、血脂异常（54.7%对41.0%，P = 0.04）、吸烟（42.7%对29.1%，P = 0.03）和缺乏身体活动（65.8%对41.9%，P<0.001）在病例组中更为普遍。病例组的住院次数增加（1.8±1.2次对0.7±0.9次，P<0.001）、住院时间延长（10.5±5.4天对6.2±3.8天，P<0.001）、30天再住院率升高（21.4%对8.5%，P = 0.007）以及重症监护病房（ICU）入院发生率更高（17.1%对6.0%，P = 0.01）。病例组的全因死亡率（35.9%对17.1%，P = 0.001）、心血管死亡率（25.6%对10.3%，P = 0.003）和MACE（51.3%对25.6%，P<0.001）更高。病例组的生活质量（45.8±12.4对25.6±10.3，P<0.001）和功能状态（55.6%对23.9%，P<0.001）较差。
结论
与对照组相比，CHF患者具有更高的可改变风险变量率和更差的临床结局，强调了全面风险管理的必要性。
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