Association Between End-Stage Liver Disease and Incident Heart Failure in an Integrated Health System.
J Gen Intern Med
; 38(11): 2445-2452, 2023 08.
Article
en En
| MEDLINE
| ID: mdl-37095330
ABSTRACT
BACKGROUND:
End-stage liver disease (ESLD) and heart failure (HF) often coexist and are associated with significant morbidity and mortality. However, the true incidence of HF among patients with ESLD remains understudied.OBJECTIVE:
This study aims to evaluate the association between ESLD and incident HF in a real-world clinical cohort. DESIGN ANDPARTICIPANTS:
A retrospective electronic health records database analysis of individuals with ESLD and frequency-matched controls without ESLD in a large integrated health system. MAINMEASURES:
The primary outcome was incident HF, which was defined by the International Classification of Disease codes and manually adjudicated by physician reviewers. The Kaplan-Meier method was used to estimate the cumulative incidence of HF. Multivariate proportional hazards models adjusted for shared metabolic factors (diabetes, hypertension, chronic kidney disease, coronary heart disease, body mass index) were used to compare the risk of HF in patients with and without ESLD. KEYRESULTS:
Of 5004 patients (2502 with ESLD and 2502 without ESLD), the median (Q1-Q3) age was 57.0 (55.0-65.0) years, 59% were male, and 18% had diabetes. Over a median (Q1-Q3) follow-up of 2.3 (0.6-6.0) years, 121 incident HF cases occurred. Risk for incident HF was significantly higher for patients with ESLD compared with the non-ESLD group (adjusted HR 4.67; 95% CI 2.82-7.75; p < 0.001), with the majority of the ESLD group (70.7%) having HF with preserved ejection fraction (ejection fraction ≥ 50%).CONCLUSION:
ESLD was significantly associated with a higher risk of incident HF, independent of shared metabolic risk factors, with the predominant phenotype being HF with preserved ejection fraction.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Prestación Integrada de Atención de Salud
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Enfermedad Hepática en Estado Terminal
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Insuficiencia Cardíaca
Tipo de estudio:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Female
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Humans
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Male
Idioma:
En
Revista:
J Gen Intern Med
Asunto de la revista:
MEDICINA INTERNA
Año:
2023
Tipo del documento:
Article
País de afiliación:
Estados Unidos