Open AccessThe Shrunken pore syndrome is associated with poor prognosis and lower quality of life in heart failure patients: the HARVEST‐Malmö study
Author(s) -
Xhakollari Liana,
Grubb Anders,
Jujic Amra,
Bachus Erasmus,
Nilsson Peter M.,
Leosdottir Margret,
Christensson Anders,
Magnusson Martin
Publication year - 2021
Publication title -
esc heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.787
H-Index - 25
ISSN - 2055-5822
DOI - 10.1002/ehf2.13485
Subject(s) - medicine , hazard ratio , heart failure , confidence interval , odds ratio , renal function , kidney disease , cystatin c , proportional hazards model , quality of life (healthcare) , cardiology , nursing
Aims This study aimed to investigate the association between the ‘Shrunken pore syndrome’ (SPS) and risk of death, 30 day rehospitalization, and health‐related quality of life (QoL) in heart failure (HF) patients. SPS is characterized by a difference in renal filtration between cystatin C and creatinine, resulting in a low eGFR cystatin C /eGFR creatinine ratio. Methods and results A total of 373 patients hospitalized for HF [mean age 74.8 (±12.1) years; 118 (31.6%) women] were retrieved from the HeARt and brain failure inVESTigation trial (HARVEST‐Malmö). Chronic Kidney Disease Epidemiology Collaboration (CKD‐EPI) formulas were used for estimation of glomerular filtration rate (eGFR). Presence of SPS was defined as eGFR cystatin C ≤ 60% of eGFR creatinine . In Cox regression multivariate models, associations between SPS, risk of death (median follow‐up time 1.8 years), and risk of 30 day rehospitalization were studied. Associations between SPS and impaired QoL were studied using multivariate logistic regressions. In multivariate models, SPS was associated with all‐cause mortality [124 events; hazard ratio (HR) 1.99; 95% confidence interval (95% CI) 1.23–3.21; P = 0.005] and with 30 day rehospitalization (70 events; HR 1.82; CI 95% 1.04–3.18; P = 0.036). Analyses of QoL, based on a Kansas City Cardiomyopathy Questionnaire overall score < 50, revealed that SPS was associated with higher risk of low health‐related QoL (odds ratios 2.15; CI 95% 1.03–4.49; P = 0.042). Conclusions The results of this observational study show for the first time an association between SPS and poor prognosis in HF. Further studies are needed to confirm the results in HF cohorts and experimental settings to identify pathophysiological mechanisms.