Eli Lilly and Company Indianapolis, Indiana, United States
Background: Coexisting obesity and heart failure with preserved ejection fraction (HFpEF) displays a distinct phenotype of heart failure where increased visceral adiposity plays a causal role. The epidemiology of selected clinical conditions among patients with this phenotype is not well characterized in the literature.
Objectives: To describe the incidence and prevalence of hypoglycemia, hypersensitivity reactions, gastrointestinal events (nausea, vomiting, and diarrhea), pancreatic outcomes, and thyroid cancer among adults with coexisting obesity-HFpEF in the United States
Methods: Administrative claims data for adults (≥18 years old) enrolled in the IBM MarketScan database between August 2017 and August 2019 were analyzed. Obesity, HFpEF, and events of interest were defined by ICD-9/10-CM diagnosis codes at inpatient and outpatient settings. Period prevalence rate in percentages and cumulative incidence rate per 100 person-years of events of interest were calculated. Corresponding rates were compared to general population without obesity and HFpEF.
Results: More than 36 million adults were eligible for analysis (Mean±SD age of 42.4±16.6 years; 54.4% females). The prevalence rates of events of interest among adults with concurrent obesity-HFpEF were higher than counterpart general population: hypoglycemia (14% versus 2.7%); hypersensitivity reactions (4.4% versus 2.5%); gastrointestinal events (48% versus 28%); acute pancreatitis (3.4% versus 1%); pancreatic cancer (0.3% versus 0.1%); and thyroid cancer (0.7% versus 0.5%). The incidence rates (per 100 person-years) of corresponding events in both populations were as follows: hypoglycemia (82.7 versus 27.6); hypersensitivity reactions (5.5 versus 9.1); gastrointestinal events (165.3 versus 229.4); acute pancreatitis (5.0 each population); pancreatic cancer (1.3 versus 1.1); and thyroid cancer (0.5 versus 3.6).
Conclusions: Compared to general population, patients with concurrent obesity-HFpEF are more likely to have these events as comorbidities, and are more likely to experience hypoglycemic events. These comorbidities should be considered during clinical management of this phenotype of heart failure.