TY - JOUR
T1 - Phenomapping in patients experiencing worsening renal function during hospitalization for acute heart failure
AU - Yagi, Ryuichiro
AU - Takei, Makoto
AU - Kohsaka, Shun
AU - Shiraishi, Yasuyuki
AU - Ikemura, Nobuhiro
AU - Shoji, Satoshi
AU - Niimi, Nozomi
AU - Higuchi, Satoshi
AU - Goda, Ayumi
AU - Kohno, Takashi
AU - Nagatomo, Yuji
AU - Nishihata, Yosuke
AU - Sujino, Yasumori
AU - Saji, Mike
AU - Ikegami, Yukinori
AU - Nakano, Shintaro
AU - Takahashi, Toshiyuki
AU - Fukuda, Keiichi
AU - Yoshikawa, Tsutomu
N1 - Funding Information:
Dr. Shiraishi is affiliated with a department endowed by Nippon Shinyaku Co., Ltd., Medtronic Japan Co., Ltd., and BIOTRONIK JAPAN Inc. and received research grants from the SECOM Science and Technology Foundation and the Uehara Memorial Foundation and honoraria from Otsuka Pharmaceuticals Co., Ltd. and Ono Pharmaceuticals Co., Ltd. Dr. Kohsaka received an unrestricted research grant from the Department of Cardiology, Keio University School of Medicine, Bayer Pharmaceuticals Co., Ltd., Daiichi Sankyo Co., Ltd., and Novartis Pharma Co., Ltd. These funders were not involved in the design and conduct of the study; in the collection, analysis, and interpretation of the data; nor in the preparation, review, or approval of the manuscript. The other authors have no conflicts of interest to disclose. There are no patents, products in development, or marketed products to declare.
Funding Information:
The West Tokyo Heart Failure (WET‐HF) Registry was supported by a grant from the Japan Agency for Medical Research and Development (S.K. 201439013C); a Grant‐in‐Aid for Scientific Research (T.Y. JSPS KAKENHI, 23591062, 26461088; T.K. 17K09526; S.K. 16KK0186, and 16H05215); a Grant‐in‐Aid for Young Scientists (Y.S. JSPS KAKENHI, 18 K15860; M.T. JSPS KAKENHI, 19 K16960); a Grant‐in‐Aid for Clinical Research from the Japanese Circulation Society (Y.S. 2019); a Grant‐in‐Aid from the Japanese Ministry of Health, Labour, and Welfare (S.K. H29‐Refractory Disease‐034); a Health Labour Science Research Grant (S.K. 14528506); and a Sakakibara Clinical Research Grant for the Promotion of Science (T.Y. 2012–2019).
Publisher Copyright:
© 2021 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.
PY - 2021/12
Y1 - 2021/12
N2 - Aims: The impact of worsening renal function (WRF) on the prognosis of patients with acute heart failure (AHF) remains controversial. We aimed to identify phenotypically distinct subgroups among individuals with both AHF and WRF using cluster analysis. Methods and results: Overall, the data of 483 patients with both AHF and WRF enrolled in the West Tokyo Heart Failure Registry were analysed. Using cluster analysis, we identified three phenotypically distinct subgroups (phenogroups 1, 2, and 3). We assessed the impact of WRF on the prognosis of each phenogroup by comparing the incidence of composite endpoints, including all-cause death and re-hospitalization due to heart failure, with those of a propensity score-matched, non-WRF control group. Participants in phenogroup 1 (N = 122) were the youngest (69.3 ± 13.7 years), had relatively preserved estimated glomerular filtration rate (eGFR, 70.0 ± 27.7 mL/min/1.73 m2), and reduced left ventricular ejection fraction (LVEF) (41.8 ± 13.7%). Conversely, participants in phenogroup 3 (N = 122) were the oldest (81.7 ± 8.5 years), had the worst eGFR (33.0 ± 20.9 mL/min/1.73 m2), and had preserved LVEF (51.7 ± 14.8%). The characteristics of the participants in phenogroup 2 (N = 239) were between those of phenogroups 1 and 3. The propensity score matching analysis showed that WRF was associated with a higher incidence of composite endpoints in phenogroup 1, whereas this association was not observed in phenogroups 2 and 3. Conclusions: Using cluster analysis, we revealed three phenotypically distinct subgroups of patients with both AHF and WRF. WRF was associated with worse clinical outcomes in the subgroup of younger patients with reduced LVEF and preserved renal function.
AB - Aims: The impact of worsening renal function (WRF) on the prognosis of patients with acute heart failure (AHF) remains controversial. We aimed to identify phenotypically distinct subgroups among individuals with both AHF and WRF using cluster analysis. Methods and results: Overall, the data of 483 patients with both AHF and WRF enrolled in the West Tokyo Heart Failure Registry were analysed. Using cluster analysis, we identified three phenotypically distinct subgroups (phenogroups 1, 2, and 3). We assessed the impact of WRF on the prognosis of each phenogroup by comparing the incidence of composite endpoints, including all-cause death and re-hospitalization due to heart failure, with those of a propensity score-matched, non-WRF control group. Participants in phenogroup 1 (N = 122) were the youngest (69.3 ± 13.7 years), had relatively preserved estimated glomerular filtration rate (eGFR, 70.0 ± 27.7 mL/min/1.73 m2), and reduced left ventricular ejection fraction (LVEF) (41.8 ± 13.7%). Conversely, participants in phenogroup 3 (N = 122) were the oldest (81.7 ± 8.5 years), had the worst eGFR (33.0 ± 20.9 mL/min/1.73 m2), and had preserved LVEF (51.7 ± 14.8%). The characteristics of the participants in phenogroup 2 (N = 239) were between those of phenogroups 1 and 3. The propensity score matching analysis showed that WRF was associated with a higher incidence of composite endpoints in phenogroup 1, whereas this association was not observed in phenogroups 2 and 3. Conclusions: Using cluster analysis, we revealed three phenotypically distinct subgroups of patients with both AHF and WRF. WRF was associated with worse clinical outcomes in the subgroup of younger patients with reduced LVEF and preserved renal function.
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U2 - 10.1002/ehf2.13598
DO - 10.1002/ehf2.13598
M3 - Article
C2 - 34545703
AN - SCOPUS:85115186748
VL - 8
SP - 5192
EP - 5203
JO - ESC heart failure
JF - ESC heart failure
SN - 2055-5822
IS - 6
ER -