BACKGROUND Data regarding the impact of preheart failure (HF) comorbidities on the prognosis of HF are scarce, especially in the younger HF patients. OBJECTIVES To investigate pre-existing comorbidities in HF patients versus matched controls and to assess their impact on mortality. METHODS We included all first-time in-hospital and outpatient diagnoses of HF from 1995 to 2017, and comorbidities antedating the HF-diagnosis in the Danish nationwide registries. HF patients were matched with up to five controls. One-year all-cause mortality rates and population attributable risk (PAR) were estimated for three separate age groups (≤50, 51-74 and >74 years). RESULTS Totally 280 002 patients with HF and 1 166 773 controls were included. Cardiovascular comorbidities, for example, cerebrovascular disease and ischaemic heart disease were more frequent in the oldest (17.9% and 29.7% in HF vs. 9.8% and 10.7% in controls) compared to the youngest age group (3.9% and 15.2% in HF vs. 0.7% and 0.9% in controls). Amongst patients with HF, 1-year mortality rates (per 100 person-years) were highest amongst those with >1 noncardiovascular comorbidity: ≤50 years (10.4; 9.64-11.3), 51-74 years (23.3; 22.9-23.7), >74 years (58.5; 57.9-59.0); hazard ratios 245.18 (141.45-424.76), 45.85 (42.77-49.15) and 24.5 (23.64-25.68) for those ≤50, 51-74 and >74 years, respectively. For HF patients ≤50 years, PAR was greatest for hypertension (17.8%), cancer (14.1%) and alcohol abuse (8.5%). For those aged >74 years, PAR was greatest for hypertension (23.6%), cerebrovascular disease (6.2%) and cancer (7.2%). CONCLUSIONS Heart failure patients had a higher burden of pre-existing comorbidities, compared to controls, which adversely impacted prognosis, especially in the young.

中文翻译：

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心力衰竭患者的心前衰竭合并症及其对预后的影响：一项全国性研究。

背景技术关于心前衰竭（HF）合并症对HF预后的影响的数据很少，尤其是在年轻的HF患者中。目的调查HF患者与相匹配的对照组的既往合并症，并评估其对死亡率的影响。方法我们纳入了1995年至2017年的所有首次住院和门诊HF诊断，并在丹麦全国性注册机构中合并了先于HF诊断的合并症。HF患者最多与五个对照匹配。估计了三个不同年龄组（≤50岁，51-74岁和> 74岁）的一年全因死亡率和人口归因风险（PAR）。结果共纳入280 002名HF患者和1 166 773名对照。例如，心血管合并症 与年龄最小的年龄组（HF的3.9％和15.2％，分别为HF的0.7％和0.9）相比，年龄最大的人群（HF的17.9％和29.7％，对照组的9.8％和10.7％）更常见。控件中的％）。在HF患者中，非心血管合并症> 1的患者中1年死亡率（每100人年）最高：≤50岁（10.4； 9.64-11.3），51-74岁（23.3； 22.9-23.7）， > 74年（58.5; 57.9-59.0）; ≤50岁，51-74岁和> 74岁人群的危险比分别为245.18（141.45-424.76），45.85（42.77-49.15）和24.5（23.64-25.68）。对于≤50岁的HF患者，PAR最大的是高血压（17.8％），癌症（14.1％）和酒精滥用（8.5％）。对于年龄大于74岁的人群，PAR最适用于高血压（23.6％），脑血管疾病（6.2％）和癌症（7.2％）。