Co-Morbidities in Patients with Heart Failure: An Analysis of the European Heart Failure Pilot Survey
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Aims: Co-morbidities frequently accompany heart failure (HF), contributing to increased morbidity and mortality, and an impairment of quality of life. We assessed the prevalence, determinants, regional variation, and prognostic implications of co-morbidities in patients with chronic HF in Europe. Methods and results: A total of 3226 European outpatients with chronic HF were included in this analysis of the European Society of Cardiology (ESC) Heart Failure Pilot Survey. The following co-morbidities were considered: diabetes, hyper- and hypothyroidism, stroke, COPD, sleep apnoea, chronic kidney disease (CKD), and anaemia. Prognostic implications of co-morbidities were evaluated using population attributable risks (PARs), and patients were divided into geographic regions. Clinical endpoints were all-cause mortality and HF hospitalization. The majority of patients (74%) had a least one co-morbidity, the most prevalent being CKD (41%), anaemia (29%), and diabetes (29%). Co-morbidities were independently associated with higher age (P < 0.001), higher NYHA functional class (P < 0.001), ischaemic aetiology of HF (P < 0.001), higher heart rate (P = 0.011), history of hypertension (P < 0.001), and AF (P < 0.001). Only diabetes, CKD, and anaemia were independently associated with a higher risk of mortality and/or HF hospitalization. There were marked regional differences in prevalence and prognostic implications of co-morbidities. Prognostic implications of co-morbidities (PARs) were: CKD = 41%, anaemia = 37%, diabetes = 14%, COPD = 10%, and <10% for all other co-morbidities. Conclusion: In this pilot survey, co-morbidities are prevalent in patients with chronic HF and are related to the severity of the disease. The presence of diabetes, CKD, and anaemia was independently related to increased mortality and HF hospitalization, with the highest PAR for CKD and anaemia.
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Schuett et al. independently validated the association of TMAO with poor heart failure outcomes specifically in heart failure with reduced ejection fraction patients.
“Most recently, Schuett et al. independently validated the association of TMAO with poor heart failure outcomes, specifically in heart failure with reduced ejection fraction patients184.”
From Dietary metabolism, the gut microbiome, and heart failure (2019) · cites this paper as [184]
TMAO was able to better predict outcomes compared to BNP in HFrEF patients after adjusting for traditional risk factors and renal function.
“Moreover, they found that TMAO was able to better predict outcomes compared to BNP in this population, after adjusting for traditional risk factors and renal function.”
From Dietary metabolism, the gut microbiome, and heart failure (2019) · cites this paper as [184]
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- Authors
- van Deursen, V. M., Urso, R., Laroche, C., Damman, K., Dahlström, U., Tavazzi, L., Maggioni, A. P., & Voors, A. A.
- Affiliations
- Department of Cardiology, University of Groningen , Groningen ,
- University of Siena (IT)
- EORP Department, ESC , Sophie Antipolis ,
- University of Groningen (NL)
- Linköping University Hospital (SE)
- Maria Cecilia Hospital (IT)
- Associazione Nazionale Medici Cardiologi Ospedalieri (IT)
- Corresponding author
- Voors, Adriaan A.
- Venue
- European Journal of Heart Failure
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-12-19
- Volume
- 16
- Issue
- 1
- Pages
- 103-111
- ISSN
- 1388-9842 (ISSN-L)
- 1879-0844
- OpenAlex
- W2151341839
- Cited by
- 468
- References
- 44
- Citations by year
- 2026: 14 · 2025: 31 · 2024: 29 · 2023: 46 · 2022: 44 · 2021: 45 · 2020: 50 · 2019: 41 · 2018: 48 · 2017: 39 · 2016: 41 · 2015: 24 · 2014: 13 · 2013: 1
- FWCI
- 17.89
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Journal of Heart Failure (publishedVersion)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Funders
- Amgen
- Sanofi
- Boston Scientific Corporation
- Servier
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- heart failure, comorbidities, chronic kidney disease, anemia, diabetes mellitus, all-cause mortality, heart failure hospitalization, population attributable risk, regional variation, prognosis
- MeSH terms
- Anemia, Diabetes Mellitus, Europe, Heart Failure, Humans, Outpatients, Pilot Projects, Prospective Studies, Registries, Societies, Medical, Comorbidity, Prevalence, Renal Insufficiency, Chronic
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