期刊
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
卷 78, 期 23, 页码 2281-2290出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2021.09.1360
关键词
heart failure; HFpEF; preeclampsia; pregnancy; women
资金
- Washington University Institute of Clinical and Translational Sciences from the National Center for Advancing Translational Sciences of the National Institutes of Health [UL1 TR002345]
- Agency for Healthcare Research and Quality (AHRQ) [R24 HS19455]
- Longer Life Foundation [2020-005]
Preeclampsia/eclampsia is an independent risk factor for future hospitalizations for heart failure with preserved ejection fraction (HFpEF), with a median time to onset of 32.2 months and median age at HFpEF onset of 34.0 years. Traditional (hypertension, diabetes mellitus) and sociodemographic (Black race, rurality, low income) risk factors were also associated with HFpEF and secondary outcomes.
BACKGROUND Preeclampsia is associated with increased risk of future heart failure (HF), but the relationship between preeclampsia and HF subtypes are not well-established. OBJECTIVES The objective of this analysis was to identify the risk of HF with preserved ejection fraction (HFpEF) following a delivery complicated by preeclampsia/eclampsia. METHODS A retrospective cohort study using the New York and Florida state Healthcare Cost and Utilization Project State Inpatient Databases identified delivery hospitalizations between 2006 and 2014 for women with and without preeclampsia/eclampsia. The authors identified women admitted for HF after discharge from index delivery hospitalization until September 30, 2015, using International Classification of Diseases-9th Revision-Clinical Modification diagnosis codes. Patients were followed from discharge to the first instance of primary outcome (HFpEF hospitalization), death, or end of study period. Secondary outcomes included hospitalization for any HF and HF with reduced ejection fraction, separately. The association between preeclampsia/eclampsia and HFpEF was analyzed using Cox proportional hazards models. RESULTS There were 2,532,515 women included in the study: 2,404,486 without and 128,029 with preeclampsia/eclampsia. HFpEF hospitalization was significantly more likely among women with preeclampsia/eclampsia, after adjusting for baseline hypertension and other covariates (aHR: 2.09; 95% CI: 1.80-2.44). Median time to onset of HFpEF was 32.2 months (interquartile range: 0.3-65.0 months), and median age at HFpEF onset was 34.0 years (interquartile range: 29.0-39.0 years). Both traditional (hypertension, diabetes mellitus) and sociodemographic (Black race, rurality, low income) risk factors were also associated with HFpEF and secondary outcomes. CONCLUSIONS Preeclampsia/eclampsia is an independent risk factor for future hospitalizations for HFpEF. (C) 2021 by the American College of Cardiology Foundation.
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