title: Vascular disease as a predictor of long-term mortality in patients hospitalized for new-onset heart failure.
abstract: BACKGROUND
  Comorbidities have an adverse influence on the outcome of patients with heart failure (HF).
  
  
  OBJECTIVE
  We investigated the impact of peripheral vascular disease (PVD) on long-term mortality in hospitalized patients with HF.
  
  
  METHODS
  We included prospectively consecutive patients (N=799) hospitalized for a first episode of HF in all healthcare establishments within a single French department during 2000. Patients with peripheral arterial disease and/or history of stroke were considered to have PVD. Baseline characteristics and 5-year mortality were compared according to PVD status.
  
  
  RESULTS
  PVD was diagnosed in 172 patients (22%) and clinical coronary artery disease in 302 patients (38%). Patients with PVD were older, predominantly men, smokers, and more often had diabetes and coronary artery disease. PVD was associated with an increased risk of crude 5-year overall mortality (hazard ratio [HR] 1.65, 95% confidence interval [CI] 1.35-2.03; P<0.001). After adjustment for covariates, the relationship remained significant (HR 1.33, 95% CI 1.08-1.65; P=0.008). Compared with the expected survival, the 5-year survival of the PVD group was dramatically lower (24% versus 67%). The risk of cardiovascular death was higher for PVD patients (HR 1.39, 95% CI 1.07-1.80; P=0.014). PVD probably modulates the impact of other covariates on outcome.
  
  
  CONCLUSIONS
  PVD is a potent predictor of adverse outcome in patients with new-onset HF.
authors.affiliation: Department of Cardiology, General Hospital, Toulon-La-Seyne-sur-Mer, France.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Tartière
authors.forename: Lamia
authors.initials: L
authors.lastname: Kesri-Tartière
authors.forename: Dan
authors.initials: D
authors.lastname: Rusinaru
authors.forename: Franck
authors.initials: F
authors.lastname: Lévy
authors.forename: Christophe
authors.initials: C
authors.lastname: Tribouilloy
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D005602:France / Q000453:epidemiology; D006333:Heart Failure / Q000401:mortality*; D006760:Hospitalization; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000401:mortality*; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors