Co-morbidities as Determinant of Heart Failure: A Hospital Based Matched Case-Control Study: Determinant of Heart Failure: A Hospital Based Matched

Muhammad Saad  Shafiq; Farooq Islam; Amina Maryam; Jamila Ghafoor; Abeera Akram

doi:10.54393/pbmj.v5i1.172

Authors

Muhammad Saad Shafiq Ibadat International University, Islamabad
Farooq Islam University of Lahore, Gujrat Campus, Gujrat, Pakistan
Amina Maryam Tahir Surgical Hospital, Lalamusa
Jamila Ghafoor Rehman Physiotherapy Clinic
Abeera Akram Usama Clinic, Lalamusa

DOI:

https://doi.org/10.54393/pbmj.v5i1.172

Keywords:

Comorbidities, Heart failure, Anemia, Diabetes, Sleep apnea, Hepatitis C, Rheumatoid arthritis, Gout, Hypercholesterolemia

Abstract

To evaluate the one most common combination of co-morbidities that can lead to heart failure.Methods:Total374 participants (case=187 & control=187 with 1:1) of age ≥20 included in this case control study through non probability convenient sampling from hospitals of Tehsil Wazirabad and District Gujrat.187 participants having heart failure were included in case group and 187 nothaving heart failure included in control group. Asemi structure questionnaire was used to collect data and results were compiled through SPSS software. There was no gender specification in this study.Results: Results showed thatFrequency of single disease was 55 in case group and 88 in control group. Participants having >1 disease were 51 in cases and 55 in control. Frequency of >2 diseases was 44 and 41 in case and control group respectively and in >3diseases 17 participants were in case group and 2 were in control group.As number of diseases increases in combination, frequency of participants increased in case group as compared to control group.This study was significant with P value less than 0.05 and odds ratio of combination of comorbidities was 1.213.Conclusion:Theobserved association indicated that combined effect of comorbidities is higher in case group to cause heart failure than one disease at a time.frequency becomes higher in case group as the number of diseases increases in combination such asSleep apnea, DM, Anemia and COPD (combination of four diseases) and Hypercholesterolemia, RA, DM, COPD and HCV(combination of five diseases) were more in case group than in control group. Hence we concluded that combined effect of comorbidities is higher in case group to cause heart failure than one disease at a time.

References

Savarese G, Lund LH. Global public health burden of heart failure. Cardiac failure review. 2017;3(1):7.

https://doi.org/10.15420/cfr.2016:25:2

Brake R, Jones ID. Chronic heart failure part 1: pathophysiology, signs and symptoms. Nursing Standard (2014+). 2017;31(19):54.

https://doi.org/10.7748/ns.2017.e10349

Angermann C. Comorbidities in heart failure: a key issue. European Journal of Heart Failure Supplements. 2009;8:i5-i10.

https://doi.org/10.1093/eurjhf/hfp009

Wong CY, Chaudhry SI, Desai MM, Krumholz HM. Trends in comorbidity, disability, and polypharmacy in heart failure. The American journal of medicine. 2011;124(2):136-43.

https://doi.org/10.1016/j.amjmed.2010.08.017

Kessler RC. The National Comorbidity Survey: preliminary results and future directions. International Journal of Methods in Psychiatric Research. 1995.

van der Wal HH, van Deursen VM, van der Meer P, Voors AA. Comorbidities in heart failure. Heart Failure: Springer; 2017. p. 35-66.

https://doi.org/10.1007/164_2017_27

Braunstein JB, Anderson GF, Gerstenblith G, Weller W, Niefeld M, Herbert R, et al. Noncardiac comorbidity increases preventable hospitalizations and mortality among Medicare beneficiaries with chronic heart failure. Journal of the American College of Cardiology. 2003;42(7):1226-33.

https://doi.org/10.1016/S0735-1097(03)00947-1

Sharma A, Zhao X, Hammill BG, Hernandez AF, Fonarow GC, Felker GM, et al. Trends in Noncardiovascular Comorbidities Among Patients Hospitalized for Heart Failure: Insights From the Get With The Guidelines-Heart Failure Registry. Circulation: Heart Failure. 2018;11(6):e004646.

https://doi.org/10.1161/CIRCHEARTFAILURE.117.004646

Rawshani A, Rawshani A, Franzén S, Eliasson B, Svensson A-M, Miftaraj M, et al. Mortality and cardiovascular disease in type 1 and type 2 diabetes. New England Journal of Medicine. 2017;376(15):1407-18.

https://doi.org/10.1056/NEJMoa1608664

de Groote P, Lamblin N, Mouquet F, Plichon D, McFadden E, Van Belle E, et al. Impact of diabetes mellitus on long-term survival in patients with congestive heart failure. European heart journal. 2004;25(8):656-62.

https://doi.org/10.1016/j.ehj.2004.01.010

Aune D, Schlesinger S, Neuenschwander M, Feng T, Janszky I, Norat T, et al. Diabetes mellitus, blood glucose and the risk of heart failure: A systematic review and meta-analysis of prospective studies. Nutrition, Metabolism and Cardiovascular Diseases. 2018;28(11):1081-91.

https://doi.org/10.1016/j.numecd.2018.07.005

Horwich TB, Fonarow GC, Hamilton MA, MacLellan WR, Borenstein J. Anemia is associated with worse symptoms, greater impairment in functional capacity and a significant increase in mortality in patients with advanced heart failure. Journal of the American College of Cardiology. 2002;39(11):1780-6.

https://doi.org/10.1016/S0735-1097(02)01854-5

Ference BA, Yoo W, Alesh I, Mahajan N, Mirowska KK, Mewada A, et al. Effect of long-term exposure to lower low-density lipoprotein cholesterol beginning early in life on the risk of coronary heart disease: a Mendelian randomization analysis. Journal of the American College of Cardiology. 2012;60(25):2631-9.

https://doi.org/10.1016/j.jacc.2012.09.017

Khatibzadeh, S., Farzadfar, F., Oliver, J., Ezzati, M. and Moran, A., 2013. Worldwide risk factors for heart failure: a systematic review and pooled analysis. International journal of cardiology, 168(2), pp.1186-1194.

https://doi.org/10.1016/j.ijcard.2012.11.065

Dunlay, S.M., Weston, S.A., Jacobsen, S.J. and Roger, V.L., 2009. Risk factors for heart failure: a population-based case-control study. The American journal of medicine, 122(11), pp.1023-1028.

https://doi.org/10.1016/j.amjmed.2009.04.022

Bauters, C., Lamblin, N., Mc Fadden, E.P., Van Belle, E., Millaire, A. and De Groote, P., 2003. Influence of diabetes mellitus on heart failure risk and outcome. Cardiovascular diabetology, 2(1), pp.1-16.

https://doi.org/10.1186/1475-2840-2-1

Ingelsson, E., Ärnlöv, J., Sundström, J., Zethelius, B., Vessby, B. and Lind, L., 2005. Novel metabolic risk factors for heart failure. Journal of the American College of Cardiology, 46(11), pp.2054-2060.

https://doi.org/10.1016/j.jacc.2005.07.059

Kalantar-Zadeh, K., Block, G., Horwich, T. and Fonarow, G.C., 2004. Reverse epidemiology of conventional cardiovascular risk factors in patients with chronic heart failure. Journal of the American College of Cardiology, 43(8), pp.1439-1444.

https://doi.org/10.1016/j.jacc.2003.11.039

Wilhelmsen, L., Rosengren, A., Eriksson, H. and Lappas, G., 2001. Heart failure in the general population of men-morbidity, risk factors and prognosis. Journal of internal medicine, 249(3), pp.253-261.

https://doi.org/10.1046/j.1365-2796.2001.00801.x

Nichols, G.A., Hillier, T.A., Erbey, J.R. and Brown, J.B., 2001. Congestive heart failure in type 2 diabetes: prevalence, incidence, and risk factors. Diabetes care, 24(9), pp.1614-1619.

https://doi.org/10.2337/diacare.24.9.1614