Impact of Chronic Kidney Disease on Prognosis of Heart Failure with Stable Reduced Ejection Fraction

Abstract

Background Heart failure with reduced ejection fraction (HFrEF) of Objectives We hypothesized that the presence of CKD can result in a worse prognosis in patients with HFrEF and stable EF of 1 year. Methods At our academic institution, we evaluated 2593 baseline echo studies and their subsequent echo studies to identify HFrEF patients with stable EF of 1 year. Student's T-test and chi-square test were used to assess baseline differences between CKD and non-chronic kidney disease (NCKD) patients. Kaplan Meier survival analysis was conducted and Log-rank p values were calculated to assess the association of the different groups with all-cause mortality, cardiac mortality, and HF hospitalization rates. Multivariate Cox regression was adjusted for age, gender, race, HF etiology, HTN, DLP, DM, CAD, NYHA class, and COPD. Results A total of 205 patients were included in our study. Sixty-six patients (32.1%) had CKD. Table 1 summarizes characteristics of patients. Follow up period was 62.5 ± 30.6 months. CKD patients had higher all-cause mortality (figure 1), cardiac mortality, and HF hospitalization rates than NCKD patients, p-value of 0.0001, 0.001, and 0.001 respectively. In adjusted model, all-cause mortality, cardiac mortality, and HF hospitalization rates remained significantly higher in CKD patients (HR = 2.412, 95% CI = 1.34-4.32, p-value = 0.003), (HR = 2.481, 95% CI = 1.12-5.46, p-value = 0.024), and (HR = 1.766, 95% CI = 1.20-2.59, p-value = 0.004) respectively. Conclusion In patients with HFrEF and stable EF of 1 year, we found that the presence of CKD resulted in significantly higher all-cause mortality, cardiac mortality, and HF hospitalization rates. Further studies are needed to validate our results.