P143 IMPACT OF THE NUMBERS OF COMPONENTS OF CARDIO-RENO-METABOLIC SYNDROME PLUS OBESITY ON PATIENTS WITH HEART FAILURE WITH PRESERVED EJECTION FRACTION: A SUB-ANALYSIS OF THE ARFEY-PRESER REGISTRY

Background and Objectives: The primary objective was to evaluate whether the presence of combined cardio-reno-metabolic syndrome and obesity (CRM+O) in patients with heart failure with preserve ejection fraction (HFpEF) had a greater impact on cardiovascular disease (CVD). Materials and Methods: This prospective, multicentre observational registry enrolled outpatients or those discharged from hospitals, with prior informed consent. The study spanned from December 2022 to February 2024. Inclusion criteria were: 1) presence of current signs and symptoms of heart failure and LVEF ≥50%, 2) structural heart disease, 3) elevated natriuretic peptides. CRM+O was defined according with the number of components defined as: coronary artery disease (myocardial infarction, revascularization or ≥ 50% in one coronary artery), chronic renal disease (TFG ≤60 ml/min/1.72m2), diabetes mellitus and obesity (BMI ≥30 kg/m2) Results: This sub study included 388 patients, and at least one component of CRM+O was identified in 333 (86.9%), with 1, 2, 3 and 4 components in 23.8%, 30.8%, 27.7% and 4.7%. Demographics and clinical profile comparison is presented in Table 1. With the increasing number of components of CRM+O there was a higher proportion of women, sedentarism (p=0.001), smoking (p<0.001), OSA (p<0.001), hypothyroidism (p=0.010), coronary artery disease on angiography (p<0.001) and peripheral artery disease (p=0.010). Conclusions In patients with HFpEF, a high prevalence of combined components of CRM+O was observed, and 1 out of 3 presented at least three of them. A positive correlation between increasing in the severity and comorbidities was observed, except by inverse relationship with atrial fibrillation. These findings support the interaction among HFpEF and CRM+O syndrome and suggest the need of comprehensive, multidisciplinary management.