Prognostic implications of overt congestion in heart failure with preserved ejection fraction and the interaction with spironolactone: Insights from TOPCAT

• Published in: Chinese medical journal Vol. 137; no. 10; pp. 1249 - 1251
• Main Authors: Lin, Yingwen, Zhao, Hengli, Hu, Dongtu, Huang, Jia, Peng, You, Li, Juncong, Xu, Dingli, Zeng, Qingchun
• Format: Journal Article
• Language: English
• Published: China Lippincott Williams & Wilkins Ovid Technologies 20-05-2024; Lippincott Williams & Wilkins; Wolters Kluwer
• Subjects: Body mass index; Chronic obstructive pulmonary disease; Clinical outcomes; Correspondence; Creatinine; Diabetes; Diuretics; Edema; Ejection fraction; Heart failure; Heart Failure - drug therapy; Humans; Male; Mineralocorticoid Receptor Antagonists - therapeutic use; Nitrates; Prognosis; Spironolactone - therapeutic use; Statistical analysis; Statistical methods; Stroke Volume - drug effects; Stroke Volume - physiology
• ISSN: 0366-6999; 2542-5641
• DOI: 10.1097/CM9.0000000000002870

To the Editor: Heart failure with preserved ejection fraction (HFpEF) is a clinical entity characterized by impaired diastolic function. [...]recently, there have been few studies directly evaluating how volume status impacts future cardiac events for patients with HFpEF. The primary endpoint in the study was defined as the composite of cardiovascular death, hospitalization for heart failure, or aborted cardiac arrest. A total of 11 covariates, namely age, sex, white race, body mass index (BMI), diabetes, chronic obstructive pulmonary disease (COPD), creatinine, albumin, nitrate use, diuretic use, and randomization to spironolactone treatment, were adjusted in the evaluation of the impact of congestive status on clinical outcomes. Determining the real congestion status by multiple physical signs might be challenging, especially when their presence is not consistent, which is common in the clinical setting. [...]using a statistical method such as LCA to identify clinical phenotypes could be a feasible option.