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ORIGINAL RESEARCH article

Front. Cardiovasc. Med.
Sec. Cardiovascular Epidemiology and Prevention
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1470216
This article is part of the Research Topic Influence of Lifestyle on Cardiometabolic Diseases View all 5 articles

Impact of comorbid constipation on the survival of patients with heart failure: A multicenter, prospective cohort study conducted in Japan

Provisionally accepted
Tomoaki Ishida Tomoaki Ishida 1*Kei Kawada Kei Kawada 2Kohei Jobu Kohei Jobu 1Tomoyuki Hamada Tomoyuki Hamada 1Toru Kubo Toru Kubo 1Moemi Okazaki Moemi Okazaki 1Kazuya Kawai Kazuya Kawai 3Yoko Nakaoka Yoko Nakaoka 3Toshikazu Yabe Toshikazu Yabe 4Takashi Furuno Takashi Furuno 5Eisuke Yamada Eisuke Yamada 6Hiroaki Kitaoika Hiroaki Kitaoika 1*Yukihiro Hamada Yukihiro Hamada 1
  • 1 Kochi Medical School Hospital, Nankoku, Japan
  • 2 Tokushima University, Tokushima, Tokushima, Japan
  • 3 Chikamori Hospital, Kochi, Kōchi, Japan
  • 4 Kochi Prefectural Hatakenmin Hospital, Sukumo, Japan
  • 5 Kochi Prefectural Aki General Hospital, Aki city, Japan
  • 6 Susaki Kuroshio Hospital, Susaki city, Japan

The final, formatted version of the article will be published soon.

    Background: Constipation frequently affects heart failure patients because of medication side effects and physiological effects of the condition. Although recent speculation suggests that comorbid constipation may affect cardiovascular disease onset and survival rates, this relationship remains unclear. We examined the effect of comorbid constipation on the survival of patients with heart failure. Methods: We conducted a multicenter prospective cohort study (the Kochi YOSACOI study) of patients hospitalized for acute decompensated heart failure. The influence of comorbid constipation on survival was evaluated using Cox regression analysis with 2-year survival as the index. Patients were divided into two groups based on the presence of comorbid constipation. The patient background was adjusted using propensity score matching, and the evaluation included assessing the 2-year survival and cardiovascular mortality occurrence using the log-rank test. Results: Among 1,061 patients hospitalized for acute decompensated heart failure, 715 with complete data (124 with comorbid constipation and 591 without) were analyzed. Comorbid constipation was identified as a risk factor for poorer survival in the Cox regression model (hazard ratio: 1.90, 95% confidence interval: 1.3–2.8, P<0.001). Propensity score matching included 104 patients in each group. Survival analysis using the log-rank test indicated worse survival (P = 0.023) and higher cardiovascular mortality (P = 0.043) in the comorbid constipation group. Conclusion: Constipation can negatively affect the survival of patients with heart failure. Although the causal link between constipation and decreased survival remains unclear, identifying comorbid constipation is essential for identifying heart failure patients at a higher risk of poor outcomes.

    Keywords: Heart Failure, Constipation, Risk factors, Propensity score matching, Mortality

    Received: 25 Jul 2024; Accepted: 26 Dec 2024.

    Copyright: © 2024 Ishida, Kawada, Jobu, Hamada, Kubo, Okazaki, Kawai, Nakaoka, Yabe, Furuno, Yamada, Kitaoika and Hamada. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Tomoaki Ishida, Kochi Medical School Hospital, Nankoku, Japan
    Hiroaki Kitaoika, Kochi Medical School Hospital, Nankoku, Japan

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