Abstract 12772: Dilated Inferior Vena Cava, Depression, Sleep Apnea Syndrome are Independent Risk Factors of Readmission in Heart Failure Patients with Preserved Ejection Fraction
Purpose: The number of patients with heart failure (HF) with preserved ejection fraction (HFpEF) has been relatively increasing compared with the number of HF patients with reduced EF (HFrEF), and the prognosis of such patients still remains poor. However, few studies report on the risk factors for readmission for HFpEF. Hence, our goal was to identify risk factors for readmission of patients with HF, particularly of those with preserved EF (pEF).
Methods: In total, 310 patients who were hospitalized for the first time with HF were enrolled in this study, 142 of whom were classified as pEF. The study endpoint was readmission for HF after discharge. Data regarding medical history, vital signs, electrocardiogram, chest X-rays, blood tests, and echocardiograms were collected and compared between patients with pEF and those with reduced EF (rEF). The chi-square test, Student’s t-test, and Kaplan-Meier survival curves were used to compare variables between the patients, as appropriate. Univariate analysis was performed on all items, and those with statistical significance were selected. Multivariate analysis was performed on variables with a value of P ≤ 0.05 using the stepwise multiple regression approach (step-up method).
Results: Of the 142 pEF patients, 43 reached the endpoint over 1 year. Multivariate analysis revealed sleep apnea syndrome (SAS) [hazard ratio (HR): 8.532], depression (HR: 8.467), dilated inferior vena cava (IVC) at admission (HR: 1.090), and high brain natriuretic peptide (BNP) level at discharge (HR: 1.003) as independent risk factors for readmission. In contrast, 39 of 168 rEF patients reached the endpoint. Risk factors for rEF patient readmission were low sodium (HR: 0.856), high blood urea nitrogen level (HR: 1.059), and high BNP (HR: 1.003) level at discharge, and absence of beta-blocker use (HR: 0.473). We calculated the Kaplan-Meier survival curves and compared them using log-rank tests. Significant differences were shown for all factors.
Conclusion: Our study suggests SAS, depression, dilated IVC at admission, higher BNP level at discharge were predictors of readmission for the Japanese HFpEF patients.
- © 2013 by American Heart Association, Inc.