Vascular disease as a predictor of long-term mortality in patients hospitalized for new-onset heart failure.
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.
Tartière
Jean-Michel
JM
Department of Cardiology, General Hospital, Toulon-La-Seyne-sur-Mer, France.
Kesri-Tartière
Lamia
L
Rusinaru
Dan
D
Lévy
Franck
F
Tribouilloy
Christophe
C
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