Table 2.
Physician-identified primary reason for worsening heart failure leading to first heart failure hospitalization
| n (%) | All patients (n=1,668) | EF≤40% (n=1,152) | EF>40% (n=516) | P* |
|---|---|---|---|---|
| Cardiovascular reasons | 895 (54) | 628 (55) | 267 (52) | 0.294 |
| Arrhythmia | 252 (15) | 169 (15) | 83 (16) | 0.456 |
| Non-compliance/inappropriate decrease in HF therapy | 160 (9.6) | 121 (11) | 39 (7.6) | 0.059 |
| Dietary indiscretion/excessive oral fluid intake/IV fluids | 139 (8.3) | 95 (8.3) | 44 (8.5) | 0.848 |
| Myocardial ischemia/angina | 130 (7.8) | 85 (7.4) | 45 (8.7) | 0.344 |
| Worsening HF/disease progression | 121 (7.3) | 104 (9.0) | 17 (3.3) | <0.001 |
| Valvular disease | 42 (2.5) | 25 (2) | 17 (3.3) | 0.175 |
| Uncontrolled hypertension | 30 (1.8) | 14 (1.2) | 16 (3.1) | 0.007 |
| Other CV reasons | 21 (1.3) | 15 (1.3) | 6 (1.2) | 0.814 |
| Non-cardiovascular reasons | 538 (32) | 358 (31) | 180 (35) | 0.124 |
| Respiratory infection | 174 (10) | 115 (10) | 59 (11) | 0.370 |
| Worsening renal function/renal failure | 61 (3.7) | 36 (3.1) | 25 (4.8) | 0.084 |
| Other infection | 35 (2.1) | 22 (1.9) | 13 (2.5) | 0.422 |
| Anemia | 32 (1.9) | 16 (1.4) | 16 (3.1) | 0.018 |
| COPD/asthma | 16 (1.0) | 13 (1.1) | 3 (0.6) | 0.417 |
| Exertion/increased exercise | 13 (0.8) | 13 (1.1) | 0 | 0.013 |
| Depression/anxiety/emotional stress | 10 (0.6) | 7 (0.6) | 3 (0.6) | 0.949 |
| Diabetes/diabetes medication related reasons | 9 (0.5) | 2 (0.2) | 7 (1.4) | 0.005 |
| NSAID use | 9 (0.5) | 7 (0.6) | 2 (0.4) | 0.729 |
| Other non-CV reasons | 179 (11) | 127 (11) | 52 (10) | 0.564 |
| Unknown reason | 235 (14) | 166 (14) | 69 (13) | 0.573 |
*
Chi squared or Fisher’s exact test comparing two EF groups, as appropriate.
EF: Ejection fraction, HF: Heart failure, CV: Cardiovascular, COPD: Chronic obstructive pulmonary disease, NSAID: Non-steroidal anti-inflammatory drugs