Predictors of mortality in patients with heart failure and preserved systolic function in the Digitalis Investigation Group trial.
OBJECTIVE
We identified predictors of mortality in patients with preserved ejection fraction (EF) and clinical heart failure (HF).


BACKGROUND
Although diastolic HF is common, the factors that predict mortality have not been clearly defined.


METHODS
We studied 988 patients with HF and preserved EF enrolled in the Digitalis Investigation Group (DIG) trial. Survival analyses were employed to identify variables associated with mortality.


RESULTS
During 3.1 years of follow-up, 231 (23%) patients died. Among 18 variables considered, the strongest independent predictors of death were glomerular filtration rate (adjusted hazard ratio for one standard deviation decrease 1.50, 95% confidence interval [CI] 1.35 to 1.67, p < 0.0001), New York Heart Association functional class III or IV (adjusted hazard ratio 1.64, 95% CI 1.20 to 2.18, p = 0.0011), male gender (adjusted hazard ratio 1.71, 95% CI 1.26 to 2.32, p = 0.0005), and older age (adjusted hazard ratio for one standard deviation increase of age2 1.28, 95% CI 1.08 to 1.50, p = 0.0019). A risk score was developed to estimate long-term mortality.


CONCLUSIONS
Diastolic HF is associated with a high death rate. Important predictors of death include impaired renal function, worse functional class, male gender, and older age.
Jones
R Christopher
RC
Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Francis
Gary S
GS
Lauer
Michael S
MS
D000368:Aged; D015992:Body Mass Index; D005260:Female; D005919:Glomerular Filtration Rate; D006333:Heart Failure / Q000401:mortality* / Q000503:physiopathology; D006801:Humans; D008297:Male; D015337:Multicenter Studies as Topic; D011379:Prognosis; D012307:Risk Factors; D016019:Survival Analysis