A study led by Victoria Cendrós, a researcher at IDIAP Jordi Gol, recently published in the International Journal of Cardiology Cardiovascular Risk and Prevention, concludes that a high percentage of people with heart failure with preserved ejection fraction who have been previously hospitalized are at risk of death or severe cardiac decompensation. The work analyzes data from patients seen in primary care over a five-year period and is the first of its kind conducted in Spain.
The research indicates that patients with low hemoglobin levels had a worse prognosis. It also identifies advanced age, male sex, and a high comorbidity index as relevant risk factors.
The study shows that 29.8 % of the 2,895 patients studied died and 28.7 % experienced at least one hospital readmission. Factors such as age over 75 years, the presence of atrial fibrillation, and the use of diuretics were associated with an increased risk of readmission. Low hemoglobin had a negative impact on both mortality and hospitalizations, underscoring the importance of laboratory markers in risk stratification.
Clinical frailty
The profile of the patients studied reveals a high level of clinical frailty. Women, who made up 57 % of the cohort, had higher rates of obesity and chronic kidney disease, while men had more coronary artery disease. The research team found that patients with a body mass index below 30 kg/m² experienced higher mortality, a phenomenon known as the obesity paradox. According to the study, these sex and comorbidity differences could influence therapeutic management and treatment response.
The study was based on information extracted from the Information System for the Development of Research in Primary Care (SIDIAP), which collects anonymized clinical data from over 80 % of the Catalan population. This database enabled a detailed analysis of demographic, clinical, and pharmacological factors related to mortality and readmissions. However, the absence of biomarkers such as NT-proBNP and data on specific causes of death are inherent limitations of the retrospective design.
The conclusions point to the need to improve the identification of profiles of patients with heart failure with preserved ejection fraction and to explore prospective research lines that include biomarkers and new therapeutic options.
According to Victoria Cendrós, the first author of the study, the fact that more than 25 % of patients visited primary care in the month before admission “suggests there is a clinical window of opportunity to prevent serious events and improve the quality of life of these patients.”
Article reference
Cendrós V, Domingo M, Navas E, Muñoz MÁ, Bayés-Genís A, Verdú-Rotellar JM. Rehospitalization, mortality and associated variables in primary care patients with heart failure and preserved ejection fraction after first hospitalization. Int J Cardiol Cardiovasc Risk Prev. 2025 Mar 7;25:200391. doi: 10.1016/j.ijcrp.2025.200391. PMID: 40160695; PMCID: PMC11951197.
