PMID- 34151546 OWN - NLM STAT- MEDLINE DCOM- 20211028 LR - 20211028 IS - 2055-5822 (Electronic) IS - 2055-5822 (Linking) VI - 8 IP - 4 DP - 2021 Aug TI - Prognostic impact of Clinical Frailty Scale in patients with heart failure with preserved ejection fraction. PG - 3316-3326 LID - 10.1002/ehf2.13482 [doi] AB - AIMS: Frailty is associated with prognosis of cardiovascular diseases. However, the significance of frailty in patients with heart failure with preserved ejection fraction (HFpEF) remains to be elucidated. The purpose of this study was to examine the prognostic significance of the Clinical Frailty Scale (CFS) in real-world patients with HFpEF using data from a prospective multicentre observational study of patients with HFpEF (PURSUIT-HFpEF study). METHOD AND RESULTS: We classified 842 patients with HFpEF enrolled in the PURSUIT-HFpEF study into two groups using CFS. The registry enrolled patients hospitalized with a diagnosis of decompensated heart failure. Median age was 82 [interquartile range: 77, 87], and 45% of the patients were male. Of 842 patients, 406 were classified as high CFS (CFS >/= 4, 48%) and 436 as low CFS (CFS /= 2 (75% vs. 53%, P < 0.001) and a higher level of NT-proBNP (1360 vs 838 pg/mL, P < 0.001) than those with low CFS. Patients with high CFS had a significantly greater risk of composite endpoint (Kaplan-Meier estimated 1-year event rate 39% vs. 23%, log-rank P < 0.001), all-cause mortality (Kaplan-Meier estimated 1-year event rate 17% vs. 7%, log-rank P < 0.001) and heart failure admission (Kaplan-Meier estimated 1-year event rate 28% vs. 19%, log-rank P = 0.002) than those with low CFS. Multivariable Cox regression analysis revealed that high CFS was significantly associated with composite endpoint (adjusted HR 1.92, 95% CI 1.35-2.73, P < 0.001), all-cause mortality (adjusted HR 2.54, 95% CI 1.39-4.66, P = 0.003) and heart failure admission (adjusted HR 1.55, 95% CI 1.03-2.32, P = 0.035) even after adjustment for covariates. Moreover, change in CFS grade was also significantly associated with composite endpoint (adjusted HR 1.23, 95% CI 1.11-1.36, P < 0.001), all-cause mortality (adjusted HR 1.32, 95% CI 1.13-1.55, P = 0.001) and heart failure admission (adjusted HR 1.15, 95% CI 1.02-1.30, P = 0.021). CONCLUSIONS: Frailty assessed by the CFS was associated with poor prognosis in patients with HFpEF. CI - (c) 2021 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. FAU - Sunaga, Akihiro AU - Sunaga A AD - Department of Cardiovascular Medicine, Graduate School of Medicine, Osaka University, Suita, Japan. FAU - Hikoso, Shungo AU - Hikoso S AD - Department of Cardiovascular Medicine, Graduate School of Medicine, Osaka University, Suita, Japan. FAU - Yamada, Takahisa AU - Yamada T AD - Division of Cardiology, Osaka General Medical Center, Osaka, Japan. FAU - Yasumura, Yoshio AU - Yasumura Y AD - Division of Cardiology, Amagasaki Chuo Hospital, Amagasaki, Japan. FAU - Uematsu, Masaaki AU - Uematsu M AD - Cardiovascular Division, National Hospital Organization Osaka National Hospital, Osaka, Japan. FAU - Tamaki, Shunsuke AU - Tamaki S AD - Division of Cardiology, Osaka General Medical Center, Osaka, Japan. FAU - Abe, Haruhiko AU - Abe H AD - Cardiovascular Division, National Hospital Organization Osaka National Hospital, Osaka, Japan. FAU - Nakagawa, Yusuke AU - Nakagawa Y AD - Division of Cardiology, Kawanishi City Hospital, Kawanishi, Japan. FAU - Higuchi, Yoshiharu AU - Higuchi Y AD - Cardiovascular Division, Osaka Police Hospital, Osaka, Japan. FAU - Fuji, Hisakazu AU - Fuji H AD - Division of Cardiology, Kobe Ekisaikai Hospital, Kobe, Japan. FAU - Mano, Toshiaki AU - Mano T AD - Cardiovascular Center, Kansai Rosai Hospital, Amagasaki, Japan. FAU - Kurakami, Hiroyuki AU - Kurakami H AD - Department of Medical Innovation, Osaka University Hospital, Suita, Japan. FAU - Yamada, Tomomi AU - Yamada T AD - Department of Medical Innovation, Osaka University Hospital, Suita, Japan. FAU - Kitamura, Tetsuhisa AU - Kitamura T AD - Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita, Japan. FAU - Sato, Taiki AU - Sato T AD - Department of Cardiovascular Medicine, Graduate School of Medicine, Osaka University, Suita, Japan. FAU - Oeun, Bolrathanak AU - Oeun B AD - Department of Cardiovascular Medicine, Graduate School of Medicine, Osaka University, Suita, Japan. FAU - Kida, Hirota AU - Kida H AD - Department of Cardiovascular Medicine, Graduate School of Medicine, Osaka University, Suita, Japan. FAU - Kojima, Takayuki AU - Kojima T AD - Department of Cardiovascular Medicine, Graduate School of Medicine, Osaka University, Suita, Japan. FAU - Sotomi, Yohei AU - Sotomi Y AD - Department of Cardiovascular Medicine, Graduate School of Medicine, Osaka University, Suita, Japan. FAU - Dohi, Tomoharu AU - Dohi T AD - Department of Cardiovascular Medicine, Graduate School of Medicine, Osaka University, Suita, Japan. FAU - Okada, Katsuki AU - Okada K AD - Department of Cardiovascular Medicine, Graduate School of Medicine, Osaka University, Suita, Japan. FAU - Suna, Shinichiro AU - Suna S AD - Department of Cardiovascular Medicine, Graduate School of Medicine, Osaka University, Suita, Japan. FAU - Mizuno, Hiroya AU - Mizuno H AD - Department of Cardiovascular Medicine, Graduate School of Medicine, Osaka University, Suita, Japan. FAU - Nakatani, Daisaku AU - Nakatani D AD - Department of Cardiovascular Medicine, Graduate School of Medicine, Osaka University, Suita, Japan. FAU - Sakata, Yasushi AU - Sakata Y AD - Department of Cardiovascular Medicine, Graduate School of Medicine, Osaka University, Suita, Japan. CN - OCVC-Heart Failure Investigators LA - eng PT - Journal Article PT - Multicenter Study PT - Observational Study PT - Research Support, Non-U.S. Gov't DEP - 20210620 PL - England TA - ESC Heart Fail JT - ESC heart failure JID - 101669191 SB - IM MH - Aged, 80 and over MH - Female MH - *Frailty MH - *Heart Failure MH - Humans MH - Male MH - Prognosis MH - Prospective Studies MH - Stroke Volume PMC - PMC8318468 OTO - NOTNLM OT - Frailty; Heart failure with preserved ejection fraction; Clinical Frailty Scale COIS- Shungo Hikoso has received remuneration from Daiichi Sankyo Company and received research funding from Roche Diagnostics, FUJIFILM Toyama Chemical and Actelion Pharmaceuticals. Yoshiharu Higuchi has received remuneration from Daiichi Sankyo Company. Hiroya Mizuno has received endowed department from Terumo. Yohei Sotomi has received remuneration from Abbott Vascular Japan, Boston Scientific Japan and received research funding from Abbott Vascular Japan and endowed department from Terumo. Yasushi Sakata received remuneration from Otsuka Pharmaceutical, Ono Pharmaceutical, Daiichi Sankyo Company and AstraZeneca K.K. and received research funding form Otsuka Pharmaceutical, Daiichi Sankyo Company, Mitsubishi Tanabe Pharma Corporation, Astellas Pharma, Kowa Company, Boehringer Ingelheim Japan and Biotronik. Other authors (Akihiro Sunaga, Takahisa Yamada, Yoshio Yasumura, Shunsuke Tamaki, Haruhiko Abe, Yusuke Nakagawa, Hisakazu Fuji, Toshiaki Mano, Hiroyuki Kurakami, Tomomi Yamada, Tetsuhisa Kitamura, Taiki Sato, Bolrathanak Oeun, Hirota Kida, Takayuki Kojima, Tomoharu Dohi, Katsuki Okada, Shinichiro Suna and Daisaku Nakatani) have no conflicts of interest to report. EDAT- 2021/06/22 06:00 MHDA- 2021/10/29 06:00 PMCR- 2021/06/20 CRDT- 2021/06/21 06:25 PHST- 2021/05/24 00:00 [revised] PHST- 2020/10/05 00:00 [received] PHST- 2021/06/06 00:00 [accepted] PHST- 2021/06/22 06:00 [pubmed] PHST- 2021/10/29 06:00 [medline] PHST- 2021/06/21 06:25 [entrez] PHST- 2021/06/20 00:00 [pmc-release] AID - EHF213482 [pii] AID - 10.1002/ehf2.13482 [doi] PST - ppublish SO - ESC Heart Fail. 2021 Aug;8(4):3316-3326. doi: 10.1002/ehf2.13482. Epub 2021 Jun 20.