Heart Failure Mortality in End-Stage Renal Failure: The Fatal Crossover

Document Type

Conference Proceeding

Publication Date

4-2-2024

Publication Title

Journal of the American College of Cardiology

Abstract

Background: Cardiovascular disease is the leading cause of death among end-stage renal failure (ESRF) patients, yet real-world heart failure (HF) mortality data particularly after advanced heart failure therapies, remains scarce. Methods: We queried the CDC WONDER database among patients ≥ 25 years old from 2011 to 2020. Patients with ESRF who died from heart failure were identified. We calculated age-adjusted mortality rates (AAMR) per 1,000,000 individuals and determined the trends over time by using the Joinpoint regression program. Results: Among the 2,171,883,502 individuals ≥ 25 years old, 13,453 had ESRF and died from HF. The AAMR decreased from 5.6 (95% CI, 5.3-5.9) in 2011 to 3.9 (95% CI, 3.7-4.2) in 2013 but increased to 6.4 (95% CI, 6.0- 6.7) in 2020. Within the period, the AAMR among patients with ESRF increased by 40.4%, compared to 66.8% in those without. Men had higher AAMR compared to women (7.1 [95% CI, 7.0 - 7.3] vs. (4.4 [95% CI, 4.3 - 4.5]). Among all races, African American patients had the highest AAMR of 7.2 (95% CI, 6.9 - 7.4). 43.3% of patients died during hospitalization, followed by nursing facility (26.4%), home (22.2%), and outpatient/ emergency room (4.9%). Geographically, South region had the highest AAMR (6.1 [95% CI, 6.0 - 6.3]) whereas urban and rural regions have comparable AAMR. Conclusion: HF-related deaths in ESRF patients rose notably after 2013. There is a need to optimize cardioprotective treatment strategies and implement policy changes to address demographic disparities.

Volume

83

Issue

13 Suppl

First Page

333

Comments

American College of Cardiology 73rd Annual Scientific Session & Expo, April 6-8, 2024, Atlanta, GA

DOI

10.1016/S0735-1097(24)02323-4

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