Geriatric Vulnerabilities Among Adults With Heart Failure With Preserved Ejection Fraction

作者：Parag Goyal, Omar Zainul, Yashika Sharma, Alexandra Reich, Princess Osma, Jennifer D. Lau, Efthalia Massou, Meghan Reading Turchioe, David H. Russell, Ruth Masterson Creber, Christi Deaton · 发表于：JACC Advances · 年份：2025 · DOI：10.1016/j.jacadv.2025.101602 · 被引用次数：8 · 研究领域：Heart Failure Treatment and Management、Frailty in Older Adults、Cardiovascular Function and Risk Factors

BACKGROUND: Heart failure with preserved ejection fraction (HFpEF) disproportionately affects older adults. OBJECTIVES: This study aimed to elucidate the prevalence and prognostic implications of geriatric vulnerabilities across multiple health domains in HFpEF. METHODS: We examined consecutive patients with HFpEF enrolled from the Weill Cornell Medicine (WCM) and the OPTIMISE HFpEF Programs. The primary exposure was the following: multimorbidity, polypharmacy, cognitive impairment, depressive symptoms, frailty, and limited mobility. The primary outcome was a 1-year composite of all-cause hospitalization and mortality. We conducted Cox proportional hazard models to examine associations of the primary outcome with each geriatric vulnerability and the number of impaired domains, adjusting for race and the Meta-Analysis Global Group in Chronic Heart Failure risk score. RESULTS: The WCM cohort included 188 patients with a median age of 76.3 years, the majority of which were NYHA functional class III HF (52.1%); the OPTIMISE cohort included 93 patients with a median age of 79.6 years, the majority of which were NYHA functional class II HF (62.0%). Nearly half of each cohort (42.6% WCM, 46.2% OPTIMISE) had geriatric vulnerabilities spanning all 3 health domains. In fully adjusted models, frailty (WCM: HR: 2.89, 95% CI: 1.65-5.09; OPTIMISE: HR: 2.89, 95% CI: 1.65-5.09) and an increasing number of impaired domains were associated with the primary outcome: with 3 impaired domains conf...