Multimorbidity, risk factors and causes of death in patients with cardiovascular diseases during long-term posthospital monitoring

Objective. To conduct a comparative analysis of the frequency, causes, and risk factors of death in patients with cardiovascular diseases according to long-term follow-up after hospitalization in various departments of a multifaceted hospital. Materials and methods. Multimorbidity, history of coronavirus infection (COVID-19), frequency, causes, and risk factors of death during the follow-up period of 2.6 [2.3; 2.8] years were assessed in 13/551 patients with cardiovascular diseases (CVD) after discharge from the various departments in the proSpective registry Of a multiFaceted medIcal cenTer (SOFIT). Results. Two or more CVDs and non-cardiac diseases were reported in 81.4% of cases, cardiovascular multimorbidity in 47.5%, non-cardiac multimorbidity in 52.4%, and their combination in 17.9% of patients. 15.5% of patients died. On average, the highest mortality per year was reported in patients discharged from the emergency cardiology department (9.0%), the lowest from the cardiology department (4.4%), and from the departments of therapeutic and other profiles — 5.6 and 6.6%, respectively. The proportion of deaths from cardiovascular causes among deceased patients with CVD was 35.8%. The mortality risk was associated with age and male sex, increased by 1.2—1.7 times in the presence of a history of myocardial infarction, cerebrovascular accident, diabetes mellitus, chronic obstructive pulmonary disease, or inpatient treatment for COVID-19. The COVID-19-related mortality risk increased with age, and was several times lower in patients with a history of previous outpatient and inpatient treatment for this disease (8.2 and 4.9 times). Conclusion. In patients with cardiovascular diseases, monitored in the long-term follow-up after treatment in a multifaceted hospital, multimorbidity was reported in 81.4% of cases, both cardiovascular and non-cardiac multimorbidity in about 50% of cases, and their combination in 17.9% of patients. 15.5% of patients died. The mean proportion of deaths per year was the highest among those discharged from the emergency cardiology department (9.0%), and the lowest from the cardiology department (4.4%). Cardiovascular causes of death were reported in a minority of deceased cardiovascular patients due to non-cardiac comorbidity. The risk of death from all and cardiovascular causes was associated with age, male sex, previous myocardial infarction, cerebrovascular accident, diabetes mellitus, chronic obstructive pulmonary disease, and a history of inpatient treatment for COVID-19. In patients with cardiovascular diseases, the higher risk of COVID-19-related mortality associated with age was several times lower in those with a history of the disease.