ESC Heart Failure (Oct 2022)

Insomnia in patients with acute heart failure: from the KCHF registry

  • Yuta Seko,
  • Erika Yamamoto,
  • Takao Kato,
  • Takeshi Morimoto,
  • Hidenori Yaku,
  • Yasutaka Inuzuka,
  • Yodo Tamaki,
  • Neiko Ozasa,
  • Masayuki Shiba,
  • Yusuke Yoshikawa,
  • Yugo Yamashita,
  • Takeshi Kitai,
  • Ryoji Taniguchi,
  • Moritake Iguchi,
  • Kazuya Nagao,
  • Takafumi Kawai,
  • Akihiro Komasa,
  • Ryusuke Nishikawa,
  • Yuichi Kawase,
  • Takashi Morinaga,
  • Mamoru Toyofuku,
  • Yutaka Furukawa,
  • Kenji Ando,
  • Kazushige Kadota,
  • Yukihito Sato,
  • Koichiro Kuwahara,
  • Takeshi Kimura,
  • for the KCHF Study Investigators

DOI
https://doi.org/10.1002/ehf2.14025
Journal volume & issue
Vol. 9, no. 5
pp. 2988 – 2996

Abstract

Read online

Abstract Aims Insomnia is a known risk factor for heart failure (HF) and a predictor of cardiac events in HF patients, but the clinical significance of insomnia in patients with acute HF (AHF) is not adequately evaluated. This study aimed to investigate the association between insomnia and subsequent clinical outcomes in patients with AHF. Methods From the Kyoto Congestive Heart Failure registry, consecutive 3414 patients hospitalized for HF who were discharged alive were divided into the 2 groups at discharge: insomnia group and non‐insomnia group. We compared baseline characteristics and 1 year clinical outcomes according to the presence of insomnia. The primary outcome measure was all‐cause death. Results There were 330 patients (9.7%) and 3084 patients (90.3%) with and without insomnia, respectively. In the multivariable logistic regression analysis, brain‐type natriuretic peptide above median value at discharge (OR = 1.50, 95% CI = 1.08–2.10, P = 0.02) and the presence of oedema at discharge (OR = 4.23, 95% CI = 2.95–6.07, P < 0.001) were positively associated with insomnia at discharge, whereas diuretics at discharge (OR = 0.60, 95% CI = 0.39–0.90, P = 0.01) were negatively associated with insomnia at discharge. The cumulative 1 year incidence of all‐cause death was significantly higher in the insomnia group than in the non‐insomnia group (25.1% vs. 16.2%, P < 0.001). Even after adjusting the confounders, the higher mortality risk of patients with insomnia relative to those without insomnia remained significant (HR = 1.55, 95% CI = 1.24–1.94; P < 0.001). Conclusions Patients with insomnia at discharge were associated with a higher risk of mortality than those without insomnia at discharge.

Keywords