Abstract
INTRODUCTION: There is a paucity of studies providing insights into the progression of primary care patients with heart failure and preserved ejection fraction (HFpEF). OBJETIVE: To investigate the characteristics associated with mortality and rehospitalizations in primary care patients with heart failure and preserved ejection fraction (HFpEF), previously hospitalized. METHODS: Retrospective cohort study that included primary care patients with previous heart failure (HF) hospitalization and ejection fraction ≥50 of 328 primary care centers of Catalonia. Demographic, comorbidities, clinical, and treatment variables were collected. Outocomes: Mortality and HF rehospitalization. Adjusted Cox regression models were performed. RESULTS: Study included 2895 patients. Mean age was 77(SD 9.7) years, 57 % were female. Mean follow up was 2.0[1.0-9.0] years. A total of 864(29.8 %) patients died, 831(28.7 %) were hospitalized. Mortality was associated with male sex(HR 1.26, 95 % CI 1.06-1.49), age >75 years(HR 2.76, 95 % CI 2.24-3.39), Charlson Index(HR 2.03, 95 % CI 1.21-3.42), body mass index(BMI) ≤30 kg/m(2)(HR 1.44, 95 % CI 1.22-1.69) and loop diuretics(HR 1.36, 95 % CI 1.11-1.65); hemoglobin levels(HR 0.87, 95 % CI 95 % 0.82-0.91) were protective. HF rehospitalization was associated with male sex(HR 1.14, 95 % CI 1.03-1.33), age >75 years(HR 1.37, 95 % CI 1.17-1.61), atrial fibrillation(HR 1.44, 95 % CI 1.25-1.67), and loop diuretics(HR 1.37, 95 % CI 1.15-1.63). Hemoglobin(HR 0.91, 95 % CI 0.87-0.95) were protective. CONCLUSION: High proportion of HFpEF patients were hospitalized or died at 5 years follow up. Comorbidities, demographic, analytical and treatment variables played a relevant role as prognostic factors.