1. Prognostic impact of Framingham heart failure criteria in heart failure with preserved ejection fraction
- Author
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Cecilia Linde, Lars H. Lund, Gianluigi Savarese, Camilla Hage, U. Lofstrom, Jean-Claude Daubert, Erwan Donal, Karolinska Institutet [Stockholm], CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), 20110610, Stockholm County Council, 20090376, Stockholm County Council, 20100419, Swedish Heart Lung Foundation, 20080409, Swedish Heart Lung Foundation, 2013-23897-104604-23, Swedish Research Council, Center for Gender Medicine Karolinska Institutet, Stockholm, Sweden, Medtronic Bakken Research Center, Maastricht, The Netherlands, Fédération Française de Cardiologie/Société Française de Cardiologie, France, 20110120, Stockholm County Council, 00556-2009, Stockholm County Council, 20110406, Swedish Heart Lung Foundation, 20080498, Swedish Heart Lung Foundation, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Troccaz, Olivier
- Subjects
Male ,lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_specialty ,Pleural effusion ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Internal medicine ,Original Research Articles ,medicine ,Humans ,030212 general & internal medicine ,Prospective Studies ,Original Research Article ,Natriuretic peptides ,ComputingMilieux_MISCELLANEOUS ,Aged ,Aged, 80 and over ,Heart Failure ,Framingham Risk Score ,Ejection fraction ,business.industry ,Framingham criteria ,Hazard ratio ,Stroke Volume ,medicine.disease ,Prognosis ,Confidence interval ,3. Good health ,[SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Hospitalization ,Heart failure with preserved ejection fraction ,lcsh:RC666-701 ,Echocardiography ,Heart failure ,Ambulatory ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Aims This study aims to assess prognostic impact of Framingham criteria for heart failure (FC‐HF) in patients with stable heart failure (HF) with preserved ejection fraction (HFpEF). Methods and results In the prospective Karolinska‐Rennes (KaRen) study, we assessed stable HFpEF patients after an acute HF episode. We evaluated associations between the four descriptive models of HFpEF and the composite endpoint of all‐cause mortality and HF hospitalization. The descriptive models were FC‐HF alone, FC‐HF + natriuretic peptides (NPs) according to the PARAGON trial, FC‐HF + NPs + echocardiographic HFpEF criteria according to European Society of Cardiology HF guidelines, and FC‐HF + NPs + echocardiographic criteria according to the PARAGON trial. Out of the 539 patients enrolled in KaRen, 438 returned for the stable state revisit after 4–8 weeks, 13 (2.4%) patients died before the planned follow‐up, and 88 patients (16%) declined or were unable to return. Three hundred ninety‐nine patients have FC registered at follow‐up, and among these, the four descriptive models were met in 107 (27%), 82 (22%), 61 (21%), and 69 (22%) patients, and not met in 292 (73%). The 107 patients that had FC‐HF at stable state (descriptive model 1) could also be part of the other models because all patients in models 1–4 had to fulfil the FC‐HF. The patients in model 0 did not fulfil the criteria for FC‐HF but could have single FC. Of single FC, only pleural effusion predicted the endpoint [hazard ratio (HR) 3.38, 95% confidence interval (CI) 1.47–7.76, P = 0.004]. Patients without FC‐HF had better prognosis than patients meeting FC‐HF. The unadjusted associations between the four HFpEF descriptive models and the endpoint were HR 1.54, 95% CI 1.14–2.09, P = 0.005; HR 1.71, 95% CI 1.24–2.36, P = 0.002; HR 1.95, 95% CI 1.36–2.81, P = 0.001; and HR 2.05, 95% CI 1.45–2.91, P
- Published
- 2019