- 著者
-
Satoshi Katano
Toshiyuki Yano
Takanori Tsukada
Hidemichi Kouzu
Suguru Honma
Takuya Inoue
Yuhei Takamura
Ryohei Nagaoka
Tomoyuki Ishigo
Ayako Watanabe
Katsuhiko Ohori
Masayuki Koyama
Nobutaka Nagano
Takefumi Fujito
Ryo Nishikawa
Hiroyuki Takashima
Akiyoshi Hashimoto
Masaki Katayose
Tetsuji Miura
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- vol.84, no.12, pp.2224-2234, 2020-11-25 (Released:2020-11-25)
- 参考文献数
- 37
- 被引用文献数
-
5
15
Background:The clinical significance of osteoporosis in chronic heart failure (CHF) remains unclear.Methods and Results:A total of 303 CHF patients (75 years, [interquartile range (IQR) 66–82 years]; 41% female) were retrospectively examined. Bone mineral densities (BMDs) at the lumbar spine, femoral neck, and total femur were measured by using dual-energy X-ray absorptiometry (DEXA), and osteoporosis was diagnosed when the BMD at any of the 3 sites was <70% of the Young Adult Mean percentage (%YAM). The prevalence of osteoporosis in CHF patients was 40%. Patients with osteoporosis were older (79 [IQR, 74–86] vs. 72 [IQR, 62–80] years), included a large percentage of females, had slower gait speed and had a lower body mass index. Multivariate logistic regression analysis indicated that sex, BMI, gait speed, loop diuretics use and no use of direct oral anticoagulants (DOACs) were independently associated with osteoporosis. Kaplan-Meier survival curves showed that the rate of death and heart failure hospitalization was higher in patients with osteoporotic BMD at 2 or 3 sites than in patients without osteoporosis (hazard ratio 3.45, P<0.01). In multivariate Cox regression analyses, osteoporotic BMD at 2 or 3 sites was an independent predictor of adverse events after adjustment for prognostic markers.Conclusions:Loop diuretics use and no DOACs use are independently associated with osteoporosis in CHF patients. Osteoporosis is a novel predictor of worse outcome in patients with CHF.