Abstract 4146113: Clinical, Sociodemographic, Lifestyle, and Genetic Factors Associated with Worsening Heart Failure: Evidence from the UK Biobank

Background: Heart failure (HF) is the leading cause of hospitalization and death. Hypothesis: This study examined the associations and clinical utilities of genetic, sociodemographic, lifestyle, laboratory, and clinical risk factors for worsening HF (WHF). Methods: Data were from 4,913 UK Biobank middle-aged adults with established HF at enrolment. WHF comprised HF admission, visit events of the emergency department due to acute congestive HF, and cardiovascular death. We performed Cox proportional hazard regression analyses to investigate the associations related to WHF after enrolment utilizing 24 variables encompassing sociodemographic, clinical, lifestyle, and laboratory data. To assess the impact of genetic factors, we additionally adjusted the polygenic risk score (PRS) for coronary artery disease (CAD). Results: Over a median follow-up of 11.5 [10.9-12.1] years, 411 (8.4%) WHF events occurred. Among the 24 variables, statistically significant hazard ratios were observed for 12 variables, with hypertension (2.20, 1.64-2.94), AF (1.99, 1.58-2.49), coronary heart disease (1.90, 1.51-2.40), and current smoking (1.77, 1.29-2.44), showing the highest hazard ratios, while female gender (0.47, 0.36-0.62) exhibited the smallest hazard ratio. After adjusting for CAD PRS, CAD PRS (HR 1.16, 1.05-1.28) showed significance in relation to WHF. In the WHF prediction model, the C index was 0.834 (0.816-0.851) with clinical variables, and it marginally increased to 0.847 (0.830-0.864) when all factors, including the genetic factor, were applied. Conclusions: Sociodemographic, clinical, laboratory, lifestyle, and genetic factors are each associated with worsening HF with male gender, hypertension, AF, CHD, diabetes, chronic obstructive pulmonary disease, low eGFR, low hemoglobin, high lipoprotein, cigarette smoking, no regular physical activity, and CAD PRS.