Chioncel, Ovidiu (12769077100)Ovidiu (12769077100)ChioncelBenson, Lina (36924461300)Lina (36924461300)BensonCrespo-Leiro, Maria G (35401291200)Maria G (35401291200)Crespo-LeiroAnker, Stefan D (57783017100)Stefan D (57783017100)AnkerCoats, Andrew J. S (35395386900)Andrew J. S (35395386900)CoatsFilippatos, Gerasimos (57396841000)Gerasimos (57396841000)FilippatosMcDonagh, Theresa (7003332406)Theresa (7003332406)McDonaghMargineanu, Cornelia (57217481200)Cornelia (57217481200)MargineanuMebazaa, Alexandre (57210091243)Alexandre (57210091243)MebazaaMetra, Marco (7006770735)Marco (7006770735)MetraPiepoli, Massimo F (7005292730)Massimo F (7005292730)PiepoliAdamo, Marianna (56113383300)Marianna (56113383300)AdamoRosano, Giuseppe M. C (7007131876)Giuseppe M. C (7007131876)RosanoRuschitzka, Frank (7003359126)Frank (7003359126)RuschitzkaSavarese, Gianluigi (36189499900)Gianluigi (36189499900)SavareseSeferovic, Petar (55873742100)Petar (55873742100)SeferovicVolterrani, Maurizio (7004062259)Maurizio (7004062259)VolterraniFerrari, Roberto (36047514600)Roberto (36047514600)FerrariMaggioni, Aldo P (57203255222)Aldo P (57203255222)MaggioniLund, Lars H (7102206508)Lars H (7102206508)Lund2025-06-122025-06-122023https://doi.org/10.1093/eurjpc/zwad151https://www.scopus.com/inward/record.uri?eid=2-s2.0-85166781720&doi=10.1093%2feurjpc%2fzwad151&partnerID=40&md5=3b9a235ec0827bb87571da68a9018fffhttps://remedy.med.bg.ac.rs/handle/123456789/2615Aims: To evaluate the prevalence and associations of non-cardiac comorbidities (NCCs) with in-hospital and post-discharge outcomes in acute heart failure (AHF) across the ejection fraction (EF) spectrum. Methods and results: The 9326 AHF patients from European Society of Cardiology (ESC)-Heart Failure Association (HFA)-EURObservational Research Programme Heart Failure Long-Term Registry had complete information for the following 12 NCCs: Anaemia, chronic obstructive pulmonary disease (COPD), diabetes, depression, hepatic dysfunction, renal dysfunction, malignancy, Parkinson's disease, peripheral vascular disease (PVD), rheumatoid arthritis, sleep apnoea, and stroke/transient ischaemic attack (TIA). Patients were classified by number of NCCs (0, 1, 2, 3, and ≥4). Of the AHF patients, 20.5% had no NCC, 28.5% had 1 NCC, 23.1% had 2 NCC, 15.4% had 3 NCC, and 12.5% had ≥4 NCC. In-hospital and post-discharge mortality increased with number of NCCs from 3.0% and 18.5% for 1 NCC to 12.5% and 36% for ≥4 NCCs. Anaemia, COPD, PVD, sleep apnoea, rheumatoid arthritis, stroke/TIA, Parkinson, and depression were more prevalent in HF with preserved EF (HFpEF). The hazard ratio (95% confidence interval) for post-discharge death for each NCC was for anaemia 1.6 (1.4-1.8), diabetes 1.2 (1.1-1.4), kidney dysfunction 1.7 (1.5-1.9), COPD 1.4 (1.2-1.5), PVD 1.2 (1.1-1.4), stroke/TIA 1.3 (1.1-1.5), depression 1.2 (1.0-1.5), hepatic dysfunction 2.1 (1.8-2.5), malignancy 1.5 (1.2-1.8), sleep apnoea 1.2 (0.9-1.7), rheumatoid arthritis 1.5 (1.1-2.1), and Parkinson 1.4 (0.9-2.1). Anaemia, kidney dysfunction, COPD, and diabetes were associated with post-discharge mortality in all EF categories, PVD, stroke/TIA, and depression only in HF with reduced EF, and sleep apnoea and malignancy only in HFpEF. Conclusion: Multiple NCCs conferred poor in-hospital and post-discharge outcomes. Ejection fraction categories had different prevalence and risk profile associated with individual NCCs. © 2023 The Author(s). Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved.Acute heart failureComorbiditiesPrognosis