AimTo assess cause‐specific death in patients with heart failure with preserved, mildly reduced, and reduced ejection fraction (HFpEF, HFmrEF, and HFrEF).Methods and resultsData were analysed from the Swedish Heart Failure Registry (SwedeHF) and the National Patient Register of patients enrolled in SwedeHF 2000–2021. Cox proportional hazards regression models were performed and adjusted for age, sex and time period. Among 100 584 patients (23% HFpEF, 23% HFmrEF, 53% HFrEF), median age (interquartile range) was 75 (66–82) and 36% were female. Of those who died within 5 years, most deaths were ascribed to cardiovascular (CV) causes across all ejection fraction (EF) categories. Within 5 years, HFpEF had higher adjusted risk of non‐CV death (hazard ratio [HR] 1.33, 95% confidence interval [CI] 1.28–1.38, p < 0.001) and lower adjusted risk of CV death (HR 0.85, 95% CI 0.82–0.88, p < 0.001) compared to HFrEF. Ischaemic heart disease (IHD) and cancer were the most common causes of CV and non‐CV death regardless of EF category. The incidence rate of CV death due to IHD was highest in HFrEF while incidence rates of CV death due to pulmonary vascular disease, stroke, valvular heart disease and atrial fibrillation increased with increasing EF. The incidence rates of non‐CV deaths due to cancer, respiratory disease, and infections increased with increasing EF.ConclusionCardiovascular death was more common than non‐CV death across all EF categories although the risk of non‐CV death within 5 years was higher with increasing EF. IHD and cancer were the most common causes of CV and non‐CV deaths, respectively, regardless of EF category.

中文翻译：

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射血分数范围内心力衰竭的具体原因死亡：对瑞典心力衰竭登记处超过 100 000 名患者的综合评估

目的评估射血分数保留、轻度降低和降低（HFpEF、HFmrEF 和 HFrEF）的心力衰竭患者的特定原因死亡。方法和结果数据分析来自瑞典心力衰竭登记处 (SwedeHF) 和国家患者登记处参加 SwedeHF 2000-2021 的患者。建立 Cox 比例风险回归模型并根据年龄、性别和时间段进行调整。在 100 584 名患者（23% HFpEF、23% HFmrEF、53% HFrEF）中，中位年龄（四分位距）为 75 岁（66-82 岁），其中 36% 为女性。在 5 年内死亡的人中，大多数死亡归因于所有射血分数 (EF) 类别的心血管 (CV) 原因。 5 年内，HFpEF 的非心血管死亡调整风险较高（风险比 [HR] 1.33，95% 置信区间 [CI] 1.28–1.38，p< 0.001）和较低的调整后心血管死亡风险（HR 0.85，95% CI 0.82–0.88，p< 0.001) 与 HFrEF 相比。无论 EF 类别如何，缺血性心脏病 (IHD) 和癌症是 CV 和非 CV 死亡的最常见原因。 HFrEF 中 IHD 引起的 CV 死亡发生率最高，而肺血管疾病、中风、瓣膜性心脏病和心房颤动引起的 CV 死亡发生率随 EF 的增加而增加。由于癌症、呼吸道疾病和感染导致的非心血管死亡的发生率随着 EF 的增加而增加。 结论 在所有 EF 类别中，心血管死亡比非心血管死亡更常见，尽管 5 年内非心血管死亡的风险更高增加 EF。无论 EF 类别如何，IHD 和癌症分别是 CV 和非 CV 死亡的最常见原因。