Abstract 13950: 5-years Mortality Of Heart Failure With Preserved, Mild Reduced, And Reduced Ejection Fractionin A 4880 Chinese Cohort

Abstract

Introduction: There are limited data on the distribution and long-term prognosis in heart failure (HF) patients categorized by ejection fraction (EF) in China. Furthermore, available evidence conflicts with the outcome of HF patients with preserved EF (HFpEF), mild reduced EF (HFmrEF), and reduced EF (HFrEF). We aimed to characterize the 5-year prognosis in 3 HF phenotypes according to EF in a cohort of hospitalized HF patients in southern China. Methods: From January 2007 to December 2014, hospitalized patients who complicated with HF were enrolled in the Cardiorenal ImprovemeNt cohort study (CIN, ClinicalTrials.gov NCT04407936). HF types were defined as HFpEF (EF ≥50%), HFmrEF (EF 40%~49%) and HFrEF (EF <40%). Kaplan-Meier and Cox proportional hazards models were constructed to examine differences in 5-year prognosis in HF patients with different phenotypes. Results: A total of 4880 HF patients (mean age: 61.8±10.3, male: 64.7%) were included: 2768 (57%) had HFpEF, 1015 (21%) had HFmrEF, and 1097 (22%) had HFrEF. With 5 years of follow-up through the end of December 2019, 1624 (27.6%) patients died. After full adjustment, HFrEF was associated with an 85% risk increased in 5-year mortality than HFpEF and with a 32% risk increased in 5-year mortality than HFmrEF. HFmrEF was associated with a 40% increased risk of 5-year mortality compared to HFpEF. (HFrEF 25.2% vs. HFpEF 13.4%, adjusted hazard ratio (aHR): 1.85[95% confidence interval (CI): 1.45- 2.35]; HFmrEF 18.1% vs. HFpEF 13.4%, aHR: 1.4 [95% CI: 1.08 - 1.81]; in addition, HFrEF25.2% vs. HFmrEF 18.1%, aHR: 1.32[95% CI: 1.02 - 1.71]). When compared with other countries and regions, the distribution of HFrEF is relatively smaller. Conclusions: In this Chinese cohort, patients with HFrEF accounts for more than a fifth of HF patients. Lower EF category was independently associated with an increased risk of mortality. Further studies in prevention and intervention are needed for all of 3 HF phenotypes.