Abstract 9458: Nutritional Status Determines Early versus Late Deaths in Patients With Heart Failure With Preserved Ejection Fraction -Insights from the PURSUIT-HFPEF Registry-

Abstract

Introduction: Understanding how patients with heart failure with preserved ejection fraction (HFpEF) die provides insight into the natural history and pathophysiology of this complex syndrome. Factors that influence early death might identify potentially modifiable risk factors that could improve the long-term outcomes Objectives: To investigate whether early and late death are associated with different baseline factors in HFpEF patients. Methods: An analysis was performed from a prospective multicenter observational registry for HFpEF (PURSUIT-HFpEF Registry) conducted in the Osaka region of Japan. A total of 1095 patients hospitalized for acute HF (diagnosed by using Framingham criteria) met the inclusion criteria: a left ventricular ejection fraction (LVEF) ≥50% and brain natriuretic peptide ≥100 pg/ml. We included 195 patients (age, 85±7 years; females, 52%; atrial fibrillation, 43%) who died after a survival discharge. Early and late deaths were defined as deaths within and over 1 year after discharge, respectively. Results: During the median survival period of 11.8 months (IQR, 5.2-24.8), 98 and 97 patients died within and over 1 year, respectively. Patients with early death were older (86±7 vs. 84±7 years, p=0.010) and had a poorer nutritional status (i.e., higher Controlling Nutritional Status [CONUT] score: 5.3±2.3 vs. 4.0±2.3, p <0.001) than those with late death. However, there was no difference in the prevalence of a female gender and the body mass index and LVEF. The cause of death did not differ between early and late deaths. Almost two thirds of deaths were from non-cardiovascular causes. After adjustment for age, gender, body mass index, and LVEF, logistic regression analysis revealed that the CONUT score of >3, above the optimal cut-off value of the score, was the only determinant to predict early death (hazard ratio 2.60, 95% confidence interval 1.20-5.65). Conclusions: A considerable number of patients with HFpEF died within 1 year after discharge. Poor nutritional status determined the early death in HFpEF patients.