Syncope and All-Cause Mortality in Heart Failure: A Propensity Score–Matched Analysis

Objective: To examine the association between syncope and all-cause mortality in a large cohort of patients with heart failure (HF) with syncope. Patients and Methods: We retrospectively identified a cohort of patients with HF and syncope from January 1, 2010, to December 31, 2015, and matched them...

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Main Authors: Pattara Rattanawong, MD, Chieh-Ju Chao, MD, Anil Sriramoju, MD, Cecilia Tagle-Cornell, MS, Juan Maria M. Farina, MD, Ellen Beirne, MBBS, Marlene E. Girardo, MS, Laura M. Koepke, MSN, Olubadewa A. Fatunde, MD, MPH, Nway L. Ko Ko, MBBS, Win-Kuang Shen, MD
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Mayo Clinic Proceedings: Innovations, Quality & Outcomes
Online Access:http://www.sciencedirect.com/science/article/pii/S2542454825000311
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author Pattara Rattanawong, MD
Chieh-Ju Chao, MD
Anil Sriramoju, MD
Cecilia Tagle-Cornell, MS
Juan Maria M. Farina, MD
Ellen Beirne, MBBS
Marlene E. Girardo, MS
Laura M. Koepke, MSN
Olubadewa A. Fatunde, MD, MPH
Nway L. Ko Ko, MBBS
Win-Kuang Shen, MD
author_facet Pattara Rattanawong, MD
Chieh-Ju Chao, MD
Anil Sriramoju, MD
Cecilia Tagle-Cornell, MS
Juan Maria M. Farina, MD
Ellen Beirne, MBBS
Marlene E. Girardo, MS
Laura M. Koepke, MSN
Olubadewa A. Fatunde, MD, MPH
Nway L. Ko Ko, MBBS
Win-Kuang Shen, MD
author_sort Pattara Rattanawong, MD
collection DOAJ
description Objective: To examine the association between syncope and all-cause mortality in a large cohort of patients with heart failure (HF) with syncope. Patients and Methods: We retrospectively identified a cohort of patients with HF and syncope from January 1, 2010, to December 31, 2015, and matched them in a 1:1 propensity analysis with patients with HF without syncope. A multivariable Cox regression model was used to estimate the association between syncope and the end point, all-cause mortality. Results: During the study period, 3449 patients with HF were diagnosed with syncope (mean ± SD age, 72.8±14.3 years). At 12 months follow-up, syncope was not an independent risk factor of all-cause mortality in overall patients with HF (hazard ratio [HR], 0.98; 95% CI, 0.91-1.04; P=.467), HF with preserved ejection fraction (EF) (HR, 1.02; 95% CI, 0.93-1.11; P=.686), HF with mid-range EF (HR, 0.92; 95% CI, 0.73-1.16; P=.494), or HF with reduced EF (HR, 0.94; 95% CI, 0.83-1.06; P=284). In the subgroup of those with cardiac implantable electronic devices, syncope significantly increased the risk of all-cause mortality in HF with reduced EF (HR, 1.28; 95% CI, 1.01-1.62; P=.038). Conclusion: Syncope was not an independent risk of all-cause mortality for patients with HF but significantly predicted the all-cause mortality in the subgroup of patients with heart failure reduced EF with cardiac implantable electronic devices.
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spelling doaj-art-55cd7af979944a2b8f4e1f96d4879eb12025-08-20T02:33:55ZengElsevierMayo Clinic Proceedings: Innovations, Quality & Outcomes2542-45482025-06-019310062010.1016/j.mayocpiqo.2025.100620Syncope and All-Cause Mortality in Heart Failure: A Propensity Score–Matched AnalysisPattara Rattanawong, MD0Chieh-Ju Chao, MD1Anil Sriramoju, MD2Cecilia Tagle-Cornell, MS3Juan Maria M. Farina, MD4Ellen Beirne, MBBS5Marlene E. Girardo, MS6Laura M. Koepke, MSN7Olubadewa A. Fatunde, MD, MPH8Nway L. Ko Ko, MBBS9Win-Kuang Shen, MD10Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, MNDepartment of Internal Medicine, University of North Dakota, Grand Forks, ND; Department of Cardiovascular Medicine (limited tenure), Mayo Clinic, Phoenix, AZDepartment of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZDepartment of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ; Department of Cardiovascular Medicine, Mayo Clinic School of Graduate Medical Education, Mayo Clinic College of Medicine and Science, Scottsdale, AZDepartment of Cardiovascular Medicine, Mayo Clinic School of Graduate Medical Education, Mayo Clinic College of Medicine and Science, Scottsdale, AZDepartment of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ; Division of Clinical Trials and Biostatistics, Mayo Clinic, Phoenix, AZDepartment of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZDepartment of Cardiovascular Medicine, Mayo Clinic School of Graduate Medical Education, Mayo Clinic College of Medicine and Science, Scottsdale, AZDepartment of Cardiovascular Medicine, Mayo Clinic School of Graduate Medical Education, Mayo Clinic College of Medicine and Science, Scottsdale, AZDepartment of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ; Correspondence: Address to Win-Kuang Shen, MD, Department of Cardiovascular Medicine, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ 85054.Objective: To examine the association between syncope and all-cause mortality in a large cohort of patients with heart failure (HF) with syncope. Patients and Methods: We retrospectively identified a cohort of patients with HF and syncope from January 1, 2010, to December 31, 2015, and matched them in a 1:1 propensity analysis with patients with HF without syncope. A multivariable Cox regression model was used to estimate the association between syncope and the end point, all-cause mortality. Results: During the study period, 3449 patients with HF were diagnosed with syncope (mean ± SD age, 72.8±14.3 years). At 12 months follow-up, syncope was not an independent risk factor of all-cause mortality in overall patients with HF (hazard ratio [HR], 0.98; 95% CI, 0.91-1.04; P=.467), HF with preserved ejection fraction (EF) (HR, 1.02; 95% CI, 0.93-1.11; P=.686), HF with mid-range EF (HR, 0.92; 95% CI, 0.73-1.16; P=.494), or HF with reduced EF (HR, 0.94; 95% CI, 0.83-1.06; P=284). In the subgroup of those with cardiac implantable electronic devices, syncope significantly increased the risk of all-cause mortality in HF with reduced EF (HR, 1.28; 95% CI, 1.01-1.62; P=.038). Conclusion: Syncope was not an independent risk of all-cause mortality for patients with HF but significantly predicted the all-cause mortality in the subgroup of patients with heart failure reduced EF with cardiac implantable electronic devices.http://www.sciencedirect.com/science/article/pii/S2542454825000311
spellingShingle Pattara Rattanawong, MD
Chieh-Ju Chao, MD
Anil Sriramoju, MD
Cecilia Tagle-Cornell, MS
Juan Maria M. Farina, MD
Ellen Beirne, MBBS
Marlene E. Girardo, MS
Laura M. Koepke, MSN
Olubadewa A. Fatunde, MD, MPH
Nway L. Ko Ko, MBBS
Win-Kuang Shen, MD
Syncope and All-Cause Mortality in Heart Failure: A Propensity Score–Matched Analysis
Mayo Clinic Proceedings: Innovations, Quality & Outcomes
title Syncope and All-Cause Mortality in Heart Failure: A Propensity Score–Matched Analysis
title_full Syncope and All-Cause Mortality in Heart Failure: A Propensity Score–Matched Analysis
title_fullStr Syncope and All-Cause Mortality in Heart Failure: A Propensity Score–Matched Analysis
title_full_unstemmed Syncope and All-Cause Mortality in Heart Failure: A Propensity Score–Matched Analysis
title_short Syncope and All-Cause Mortality in Heart Failure: A Propensity Score–Matched Analysis
title_sort syncope and all cause mortality in heart failure a propensity score matched analysis
url http://www.sciencedirect.com/science/article/pii/S2542454825000311
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