Geriatrics & gerontology international · 2025
Impact of non-cardiovascular factors on cardiovascular death in acute decompensated heart failure: Enhancing predictive models with frailty and comorbid constipation-the Constipation and Frailty Augmented AHEAD score.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Ishida Tomoaki, Kawada Kei, Jobu Kohei, Hamada Tomoyuki, Kubo Toru, Fukuda Hitoshi, Hyohdoh Yuki, Kawai Kazuya, Nakaoka Yoko, Yabe Toshikazu, Furuno Takashi, Yamada Eisuke, Kitaoka Hiroaki, Hamada Yukihiro
Аннотация
AIM: The present study investigated the influence of non-cardiovascular factors on cardiovascular deaths in patients with heart failure. Furthermore, we examined whether these factors add value to conventional risk factor-based models for predicting the occurrence of cardiovascular death.
METHODS: This multicenter prospective cohort study included patients with acute decompensated heart failure. Cardiovascular deaths were assessed using a Cox proportional hazards model, and contribution of non-cardiovascular factors was evaluated. Decision tree analyses were carried out, and risk stratification was carried out using cardiovascular death as an indicator. Improvement in predictive ability of the Atrial fibrillation, Hemoglobin, Elderly, Abnormal renal parameters, Diabetes (AHEAD) score was assessed after adding non-cardiovascular factors.
RESULTS: Of the 1061 patients hospitalized for heart failure, 715 were included in the analysis. In the Cox hazards model, the Japanese version of the cardiovascular health study score and comorbid constipation were detected as non-cardiovascular factors. The new model-Constipation and Frailty Augmented AHEAD Model (CFA-AHEAD score)-created by adding these factors to the AHEAD score, showed significantly improved predictive ability compared with the previous model.
CONCLUSIONS: Non-cardiovascular factors, such as physical frailty and comorbid constipation, affect life expectancy in patients with acute decompensated heart failure. The addition of these factors to conventional predictors might improve the predictive power of cardiovascular death. Geriatr Gerontol Int 2025; 25: 1341-1349.
METHODS: This multicenter prospective cohort study included patients with acute decompensated heart failure. Cardiovascular deaths were assessed using a Cox proportional hazards model, and contribution of non-cardiovascular factors was evaluated. Decision tree analyses were carried out, and risk stratification was carried out using cardiovascular death as an indicator. Improvement in predictive ability of the Atrial fibrillation, Hemoglobin, Elderly, Abnormal renal parameters, Diabetes (AHEAD) score was assessed after adding non-cardiovascular factors.
RESULTS: Of the 1061 patients hospitalized for heart failure, 715 were included in the analysis. In the Cox hazards model, the Japanese version of the cardiovascular health study score and comorbid constipation were detected as non-cardiovascular factors. The new model-Constipation and Frailty Augmented AHEAD Model (CFA-AHEAD score)-created by adding these factors to the AHEAD score, showed significantly improved predictive ability compared with the previous model.
CONCLUSIONS: Non-cardiovascular factors, such as physical frailty and comorbid constipation, affect life expectancy in patients with acute decompensated heart failure. The addition of these factors to conventional predictors might improve the predictive power of cardiovascular death. Geriatr Gerontol Int 2025; 25: 1341-1349.