Abstract 12656: Decreased Kidney Function in the Form of Estimated Glomerular Filtration Rate Increases the Risk of Development of Incident Hospitalized Heart Failure and Its Subtypes in Post-menopausal Women

Abstract

Introduction: While coronary heart disease is decreasing in prevalence, Heart Failure (HF) is increasing in prevalence. Effective treatment is known for Heart Failure with reduced ejection fraction (HFrEF), but there is no effective treatment for Heart Failure with preserved ejection fraction ( HFpEF). Post-menopausal women have high rates of HFpEF and the association with decreased kidney function is under-researched in this high risk group. Hypothesis and Objectives: Decreased kidney function measured as estimate glomerular filtration rate (eGFR) increases the risk of development of HF and HFpEF. Methods: Study participants are postmenopausal women (n=23,128) who had their serum creatinine levels measured, and who are free of Heart Failure at baseline, evaluated in the Women Health Initiative (WHI). eGFR was calculated using Chronic Kidney Disease-Epidemiology Collaboration equation. The association between eGFR and incident HF, HFpEF and HFrEF was evaluated using Cox proportional hazards models. eGFR was analyzed as a categorical exposure and test for trend were performed. Results: Among the 23,128 women in this study, 1486 developed HF over 272,323 person-years of follow-up. Decreased kidney function in the form of decreased eGFR was associated with increased risk of development of total HF and HFpEF. This risk was strongest in the eGFR <45 ml/min/ 1.73 m 2 (see table). Conclusion: Decreased kidney function was associated with increased risk of development of total HF and HFpEF in post-menopausal women in a dose-response manner but was only significant at eGFR < 45 ml/min/ 1.73 m 2 for HFrEF. This association is much stronger for HFpEF compared to HFrEF at this cut-point.