The Clinical Characteristics Of Noncardiac Comorbidities In The Elderly Inpatients With Heart Failure

OBJECTIVESRetrospectively analyze the clinical characteristics of the elderly heart failure(HF)inpatients with noncardiac comorbidity.METHODSInvestigating the inpatients who were discharged from November 1,2015 to October 31,2017 in department of cardiology in Fujian Medical University Union Hospital.The inpatients were finally included if they were aged 60 years or older,had NYHA class II-IV,and met the criteria of 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure.The inpatients were divided into without noncardiac comorbidity group(group 1)and with noncardiac comorbidity group(group 2).The differences in noncardiac comorbidity were also compared between the elderly heart failure with reduced ejection fraction(HFrEF)and the elderly heart failure with preserved ejection fraction(HFpEF).RESULTS256 cases were recruited in the study,in which 56 inpatients were NYHA class II,171 inpatients were NYHA class III,29 inpatients were NYHA class IV.The proportion of group 1 and group 2 was 28.9% and 71.1% respectively.Diabetes mellitus(49.6%),anemia(39.1%),and chronic kidney disease(21.5%)were the principal noncardiac comorbidities.There were more hypertension,pneumonia and smoking in group 2 than those in group 1(P<0.05).The levels of body mass index(BMI),homocysteine(Hcy)and fibrinogenin(FIB)were higher but the levels of high density lipoprotein cholesterol(HDL-C)and apolipoprotein A1(ApoA1)were lower in group 2 than those in group 1(P<0.05).Polypharmacy in group 2 was more prominent than that in group 1(95.1% vs 87.8%,P=0.041).The average hospitalization days of group 2 were longer than group 1(9.71d±5.66 d vs 8.51d±3.53 d,P=0.043).The average hospitalization days of HF inpatients with 2 or more noncardic comorbidities were longer than inpatients with 1 or without noncardiac comorbidity(10.36d±6.23 d vs 8.83d±4.41 d,P=0.042).There was no significant difference between HFrEF and HFpEF about noncardic comorbidity(P=0.22).In HFrEF,the average hospitalization days of inpatients with 2 or more noncardic comorbidities were longer than with 1 or without noncardiac comorbidity inpatients(11.39d±7.97 d vs 8.62d±4.35 d,P=0.037).However,in HFpEF,there was no significant difference in average hospitalization days of inpatients with or without noncardiac comorbidity(9.48d±4.12 d vs 9.04d±4.47 d,P=0.573).CONCLUSIONS1.The majority of the elderly inpatients with HF has noncardiac comorbidity.Diabetes mellitus,anemia and chronic kidney disease are the most common noncardiac comorbidity.The levels of HDL-C and ApoA1 are lower but the levels of Hcy,FIB and NT-proBNP are higher in the elderly HF inpatients with noncardiac comorbidity than those without noncardic comorbidity inpatients.Polypharmacy is higher and the average hospitalization days are longer in the elderly HF inpatients with noncardiac comorbidity.2.The proportion of the elderly HFpEF with noncardiac comorbidity is the same as the elderly HFrEF.However,the average hospitalization days in the elderly HFrEF with 2 or more noncardiac comorbidities are longer than HFrEF with 1 or without noncardiac comorbidity.