Table 1.
Baseline clinical and demographic characteristics of the study population by American College of Cardiology/American Heart Association heart failure stage
| ACC/AHA stage | ptrend | ||||
|---|---|---|---|---|---|
| A (n = 202) | B (n = 881) | C1 (n = 822) | C2/D (n = 591) | ||
| Demographics/clinical characteristics | |||||
| Age, years | 64 (57; 69) | 67 (62; 72) | 66 (56; 74) | 72 (60; 78) | < 0.001 |
| Female, n (%) | 102 (50.5) | 407 (46.2) | 213 (25.9) | 211 (35.7) | < 0.001 |
| Systolic blood pressure, mmHg | 144 (133; 158) | 150 (137; 164) | 123 (110; 140) | 120 (110; 130) | < 0.001 |
| Heart rate, beats/min | 72 (65; 81) | 68 (61; 78) | 72 (64; 80) | 72 (64; 80) | 0.956 |
| Body mass index, kg/m2 | 26 (25; 29) | 29 (27; 32) | 27 (24; 30) | 27 (24; 30) | 0.911 |
| NYHA class | 2.0 (2.0; 2.0) | 3.0 (3.0; 3.0) | |||
| NYHA class, n (%) | |||||
| I | 98 (11.9) | ||||
| II | 724 (88.1) | ||||
| III | 544 (92.0) | ||||
| IV | 47 (8.0) | ||||
| Comorbidities/risk factors, n (%) | |||||
| Arterial hypertension* | 192 (95.0) | 864 (98.1) | 633 (77.0) | 438 (74.2) | < 0.001 |
| Coronary artery disease | 18 (8.9) | 182 (20.7) | 371 (45.1) | 290 (49.1) | < 0.001 |
| Obesity† | 27 (13.6) | 373 (42.4) | 218 (26.7) | 159 (27.3) | 0.006 |
| Diabetes mellitus‡ | 50 (24.8) | 224 (25.5) | 226 (27.5) | 228 (38.6) | < 0.001 |
| Chronic kidney disease§ | 45 (22.3) | 208 (23.6) | 260 (31.6) | 323 (54.7) | < 0.001 |
| Anaemia|| | 6 (3.0) | 70 (7.9) | 178 (21.7) | 196 (33.2) | < 0.001 |
| Atrial fibrillation | 2 (1.0) | 30 (3.4) | 172 (20.9) | 183 (31.0) | < 0.001 |
| COPD# | 9 (4.5) | 55 (6.2) | 106 (12.9) | 117 (19.8) | < 0.001 |
| Malignancy** | 19 (9.4) | 71 (8.1) | 86 (10.5) | 74 (12.5) | 0.132 |
| Peripheral arterial disease | 6 (3.0) | 45 (5.1) | 74 (9.0) | 76 (12.9) | < 0.001 |
| Echocardiography | |||||
| LVEF, % | 62 (57; 66) | 60 (55; 65) | 33 (26; 39) | 30 (24; 35) | < 0.001 |
| LVEF < 50%, n (%) | 51 (5.8) | 714 (86.9) | 559 (94.6) | < 0.001 | |
| LV hypertrophy††, n (%) | 800 (91.4) | 628 (83.7) | 468 (89.1) | 0.157 | |
| LV dilatation, n (%) | 92 (10.5) | 458 (59.2) | 391 (71.4) | < 0.001 | |
| Diastolic dysfunction, n (%) | 204 (23.2) | 165 (20.1) | 106 (17.9) | 0.016 | |
| Wall motion abnormalities, n (%) | 167 (19.0) | 527 (66.6) | 422 (73.4) | < 0.001 | |
| Valvular disease ≥ II, n (%) | 96 (10.9) | 202 (24.6) | 219 (37.1) | < 0.001 | |
| Laboratory parameters | |||||
| Haemoglobin, g/dL | 14.2 (13.5; 15.1) | 14.1 (13.3; 14.9) | 14.1 (12.8; 15.1) | 13.4 (12.0; 14.7) | < 0.001 |
| eGFR, mL/min/1.73m2 | 75 (62; 85) | 72 (61; 85) | 71 (55; 88) | 58 (40; 77) | < 0.001 |
| Leukocytes, 109/L | 6.5 (5.5; 7.8) | 6.5 (5.6; 7.5) | 7.3 (6.2; 9.0) | 8.0 (6.5; 10.0) | < 0.001 |
| C-reactive protein, mg/L | 1.2 (0.7; 2.9) | 1.9 (1.0; 3.7) | 5.0 (2.1; 14.0) | 9.5 (5.0; 27.1) | < 0.001 |
| Total cholesterol, mg/dL | 210 (178; 234) | 199 (175; 227) | 180 (150; 209) | 168 (139; 204) | < 0.001 |
| NT-proBNP‡‡, pg/mL | 64 (38; 108) | 108 (55; 209) | 1279 (342; 3667) | 4298 (1396; 9979) | < 0.001 |
| NT-proBNP > 125 pg/mL, n (%)‡‡ | 42 (20.8) | 397 (45.1) | 588 (89.9) | 443 (98.0) | < 0.001 |
| Antihypertensive/heart failure medications, n (%) | |||||
| ACEI and/or ARB | 99 (49.3) | 569 (64.9) | 735 (89.4) | 512 (86.8) | < 0.001 |
| Beta-blocker | 63 (31.2) | 478 (54.3) | 676 (82.2) | 472 (79.9) | < 0.001 |
| Mineralocorticoid receptor antagonist | 2 (1.0) | 11 (1.2) | 299 (36.4) | 278 (47.0) | < 0.001 |
| Thiazide | 76 (37.6) | 385 (43.7) | 209 (25.4) | 132 (22.3) | < 0.001 |
| Loop diuretic | 11 (5.4) | 92 (10.4) | 521 (63.4) | 472 (79.9) | < 0.001 |
Values are median (quartiles), or number of patients (%)
ACEI angiotensin-converting enzyme inhibitor, ACC/AHA American College of Cardiology/American Heart Association, ARB angiotensin receptor blocker, COPD chronic obstructive pulmonary disease, eGFR estimated glomerular filtration rate, LV left ventricular, LVEF left ventricular ejection fraction, NT-proBNP N-terminal pro b-type natriuretic peptide; NYHA, New York Heart Association
*Arterial hypertension was defined as systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg and / or documented history of hypertension
†Obesity was defined as body mass index ≥ 30 kg/m2
‡Diabetes mellitus was defined based on antidiabetic therapy and/or history of diabetes mellitus
§Chronic kidney disease was defined as eGFR < 60 mL/min/1.73m2
||Anaemia was defined as haemoglobin < 12 g/dL in women, < 13 g/dL in men (World Health Organization criteria)
#COPD was defined based on anti-obstructive therapy and/or history of COPD
**Malignancy denotes cured and uncured malignant disease
††LV hypertrophy was measured in 2335 patients
‡‡NT-proBNP missing values at Stage C1 (20.4%) and C2/D (23.5%); all other variables were measured in > 95% of the study population