Abstract 13635: Recurrent Heart Failure Hospitalizations Increase Risk of Cardiovascular and All-Cause Mortality in Heart Failure Patients With Comorbid Atrial Fibrillation, Type 2 Diabetes Mellitus, or Renal Impairment: An Analysis From Pygargus Database in Sweden

ObjectivePrevious research suggests that recurrent heart failure hospitalizations (HFH) are a predictor of cardiovascular (CV) and all-cause mortality. Heart failure (HF) patients (pts) with comorbidities may be at increased risk. The objective of this real world study was to examine the impact of recurrent HFH on CV and all-cause mortality in HF pts with atrial fibrillation (AF), type 2 diabetes mellitus (T2DM) or chronic renal impairment (CRI) in Sweden.MethodsAdult HF pts were identified in the Pygargus database with a first (index) hospitalization due to HF from 01/01/2009 to 31/12/2011 and with an ICD-10 claim for AF, T2DM or CRI within the year prior to index hospitalization. Pts were followed until death, transfer out or end of study period (31/12/2014). CV and all-cause deaths were evaluated. A time dependent Cox regression model using stepwise selection approach was used to report adjusted CV and all-cause mortality rates for time dependent recurrent HFH versus pts without recurrent HFH. Model variables were common comorbidities, treatments and lab measures.ResultsOf 3878 pts with HF, 50.6%, 28.7% and 49.3% with comorbid AF, T2DM and CRI, respectively were included. Median follow-up was from 2.0 to 2.5 years. Median age for AF/T2DM/CRI cohorts was 81/78/83 years; male proportion was 54.1/60.5/50.0%. Recurrent HFH increased the risk of CV and all-cause mortality and the annualized mortality rates progressively increased with each individual recurrent HFH (Table 1).ConclusionsRecurrent HFH increase the risk of CV and all-cause death in HF pts with comorbidities. The relative risk of mortality increases similarly with each recurrent HFH for all comorbidity groups. The absolute increase in mortality is greater for those with a higher overall baseline risk, which is influenced by patients’ comorbidities, most notably CRI. The data highlights that there may be relevance of reducing hospitalizations in the management of HF pts with comorbidities.