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Multimorbidity in patients with acute heart failure across world regions and country income levels (REPORT-HF): a prospective, multicentre, global cohort study

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dc.contributor.author Gerhardt, Teresa
dc.contributor.author Gerhardt, Louisa M.S.
dc.contributor.author Ouwerkerk, Wouter
dc.contributor.author Roth, Gregory A.
dc.contributor.author Dickstein, Kenneth
dc.contributor.author Collins, Sean P.
dc.contributor.author Cleland, John G.F.
dc.contributor.author Dahlstrom, Ulf
dc.contributor.author Ting Tay, Wan
dc.contributor.author Ertl, Georg
dc.contributor.author Hassanein, Mahmoud
dc.contributor.author Perrone, Sergio Víctor
dc.contributor.author Ghadanfar, Mathieu
dc.contributor.author Schweizer, Anja
dc.contributor.author Obergfell, Achim
dc.contributor.author Filippatos, Gerasimos
dc.contributor.author Lam, Carolyn S. P.
dc.contributor.author Tromp, Jasper
dc.contributor.author Angermann, Christiane E.
dc.date.accessioned 2024-02-20T13:31:44Z
dc.date.available 2024-02-20T13:31:44Z
dc.date.issued 2023-12-01
dc.identifier.citation Gerhardt T, Gerhardt LMS, Ouwerkerk W, Roth GA, Dickstein K, Collins SP, Cleland JGF, Dahlstrom U, Tay WT, Ertl G, Hassanein M, Perrone SV, Ghadanfar M, Schweizer A, Obergfell A, Filippatos G, Lam CSP, Tromp J, Angermann CE. Multimorbidity in patients with acute heart failure across world regions and country income levels (REPORT-HF): a prospective, multicentre, global cohort study. Lancet Glob Health. 2023 Dec;11(12):e1874-e1884. doi: 10.1016/S2214-109X(23)00408-4. es_ES
dc.identifier.uri Gerhardt T, Gerhardt LMS, Ouwerkerk W, Roth GA, Dickstein K, Collins SP, Cleland JGF, Dahlstrom U, Tay WT, Ertl G, Hassanein M, Perrone SV, Ghadanfar M, Schweizer A, Obergfell A, Filippatos G, Lam CSP, Tromp J, Angermann CE. Multimorbidity in patients with acute heart failure across world regions and country income levels (REPORT-HF): a prospective, multicentre, global cohort study. Lancet Glob Health. 2023 Dec;11(12):e1874-e1884. doi: 10.1016/S2214-109X(23)00408-4.
dc.identifier.uri https://repositorio.fleni.org.ar/xmlui/handle/123456789/1001
dc.description.abstract Background: Multimorbidity (two or more comorbidities) is common among patients with acute heart failure, but comprehensive global information on its prevalence and clinical consequences across different world regions and income levels is scarce. This study aimed to investigate the prevalence of multimorbidity and its effect on pharmacotherapy and prognosis in participants of the REPORT-HF study. Methods: REPORT-HF was a prospective, multicentre, global cohort study that enrolled adults (aged ≥18 years) admitted to hospital with a primary diagnosis of acute heart failure from 358 hospitals in 44 countries on six continents. Patients who currently or recently participated in a clinical treatment trial were excluded. Follow-up data were collected at 1-year post-discharge. The primary outcome was 1-year post-discharge mortality. All patients in the REPORT-HF cohort with full data on comorbidities were eligible for the present study. We stratified patients according to the number of comorbidities, and countries by world region and country income level. We used one-way ANOVA, χ2 test, or Mann-Whitney U test for comparisons between groups, as applicable, and Cox regression to analyse the association between multimorbidity and 1-year mortality. Findings: Between July 23, 2014, and March 24, 2017, 18 553 patients were included in the REPORT-HF study. Of these, 18 528 patients had full data on comorbidities, of whom 11 360 (61%) were men and 7168 (39%) were women. Prevalence rates of multimorbidity were lowest in southeast Asia (72%) and highest in North America (92%). Fewer patients from lower-middle-income countries had multimorbidity than patients from high-income countries (73% vs 85%, p<0·0001). With increasing comorbidity burden, patients received fewer guideline-directed heart failure medications, yet more drugs potentially causing or worsening heart failure. Having more comorbidities was associated with worse outcomes: 1-year mortality increased from 13% (no comorbidities) to 26% (five or more comorbidities). This finding was independent of common baseline risk factors, including age and sex. The population-attributable fraction of multimorbidity for mortality was higher in high-income countries than in upper-middle-income or lower-middle-income countries (for patients with five or more comorbidities: 61% vs 27% and 31%, respectively). Interpretation: Multimorbidity is highly prevalent among patients with acute heart failure across world regions, especially in high-income countries, and is associated with higher mortality, less prescription of guideline-directed heart failure pharmacotherapy, and increased use of potentially harmful medications. es_ES
dc.language.iso eng es_ES
dc.publisher Elsevier es_ES
dc.rights info:eu-repo/semantics/openAccess
dc.subject Heart Failure es_ES
dc.subject Insuficiencia Cardíaca es_ES
dc.subject Global Health es_ES
dc.subject Salud Global es_ES
dc.title Multimorbidity in patients with acute heart failure across world regions and country income levels (REPORT-HF): a prospective, multicentre, global cohort study es_ES
dc.type info:eu-repo/semantics/article es_ES
dc.type info:eu-repo/semantics/publishedVersion
dc.description.fil Fil: Perrone, Sergio Víctor. Fleni. Departamento de Neurología. Servicio de Cardiología; Argentina.
dc.relation.ispartofVOLUME 11
dc.relation.ispartofNUMBER 12
dc.relation.ispartofPAGINATION e1874-e1884.
dc.relation.ispartofCOUNTRY Inglaterra
dc.relation.ispartofTITLE The Lancet. Global health
dc.relation.ispartofISSN 2214-109X
dc.type.snrd info:ar-repo/semantics/artículo es_ES


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