Vascular disease as a predictor of long-term mortality in patients hospitalized for new-onset heart failure

Abstract

SummaryBackgroundComorbidities have an adverse influence on the outcome of patients with heart failure (HF).AimWe investigated the impact of peripheral vascular disease (PVD) on long-term mortality in hospitalized patients with HF.MethodsWe included prospectively consecutive patients (N=799) hospitalized for a first episode of HF in all healthcare establishments within a single French department during 2000. Patients with peripheral arterial disease and/or history of stroke were considered to have PVD. Baseline characteristics and 5-year mortality were compared according to PVD status.ResultsPVD was diagnosed in 172 patients (22%) and clinical coronary artery disease in 302 patients (38%). Patients with PVD were older, predominantly men, smokers, and more often had diabetes and coronary artery disease. PVD was associated with an increased risk of crude 5-year overall mortality (hazard ratio [HR] 1.65, 95% confidence interval [CI] 1.35–2.03; P<0.001). After adjustment for covariates, the relationship remained significant (HR 1.33, 95% CI 1.08–1.65; P=0.008). Compared with the expected survival, the 5-year survival of the PVD group was dramatically lower (24% versus 67%). The risk of cardiovascular death was higher for PVD patients (HR 1.39, 95% CI 1.07–1.80; P=0.014). PVD probably modulates the impact of other covariates on outcome.ConclusionPVD is a potent predictor of adverse outcome in patients with new-onset HF