Characteristics, outcomes, and predictors of mortality at 3 months and 1 year in patients hospitalized for acute heart failure

Abstract

AimsAcute heart failure (AHF) has a poor prognosis. We evaluated 3-and 12-month mortality in different clinical classes of AHF patients from 30 European countries who were included in the EuroHeart Failure Survey (EHFS) II. Methods and resultsFollow-up data were available for 2981 AHF patients, of these 62% had a history of chronic HF. One-year mortality after discharge was lower in patients with de novo AHF when compared with acutely decompensated chronic HF (ADCHF), 16.4 vs. 23.2% (P , 0.001). Cardiogenic shock conferred the highest cumulative 1-year mortality (52.9%) as a result of in-hospital mortality of 39.3%. Long-term prognosis in decompensated AHF was also dismal. Hypertensive HF was associated with the lowest mortality (13.7% at 1 year). Age, prior myocardial infarction, creatinine level, and low plasma sodium were independently associated with mortality during the whole follow-up period. Diabetes, anaemia, and history of chronic HF were associated with worse and hypertension with better long-term survival. History of cerebrovascular disease was associated with worse short-term outcome. ConclusionEarly and late mortality differ between de novo AHF and ADCHF and between clinical classes of AHF. EHFS II identifies clinical risk markers and demonstrates the importance of a thorough characterization of AHF populations according to history and clinical presentation.--

Hospital and 4‐Year Mortality Predictors in Patients With Acute Pulmonary Edema With and Without Coronary Artery Disease

“…Predictors of 1‐year mortality appeared also to be age,12, 13, 14, 15 admission blood pressure,13, 15 anemia,13 renal failure,12, 13, 15 left ventricular dysfunction, and acute coronary syndromes 14. There are few studies (3), however, that have analyzed a longer follow‐up in patients with acutely decompensated heart failure,15, 16, 17 with mortality rates of 60.3%15 and 71%,16 with similar main predictors than in the 1‐year follow‐up series 15…”

“…Most series that have analyzed total mortality in patients with acute heart failure have reported only a 1‐year follow‐up with mortality rates ranging from 17.4% to 34%5, 11, 12, 13, 14 and higher in patients admitted to a critical care area (46.5%) 4. Predictors of 1‐year mortality appeared also to be age,12, 13, 14, 15 admission blood pressure,13, 15 anemia,13 renal failure,12, 13, 15 left ventricular dysfunction, and acute coronary syndromes 14.…”

“…Several recent studies have reported on the 1‐year prognosis of patients with acute heart failure4, 11, 12, 13, 14, 15, 16 and 3 have analyzed longer follow‐up,15, 16, 17 one of them with decompensated heart failure and pulmonary edema 17. In contrast, long‐term follow‐up in patients with well‐defined APE has been limited to 1 year and has been described in only 2 old reports with a reduced number of patients 7, 18.…”

Decompensated Chronic Heart Failure Course in Diabetes Patients

“…гнозе у 92% госпитализированных в подобные стаци-онары [7]. Следующим этапом настоящего исследования явилась сравнительная оценка гемодинамических и лабораторных показателей больных с ХСН.…”

Absence of interaction of diabetes mellitus with chronic kidney disease on mortality in acute heart failure

“…Their mortality rate was a 46% higher than for non-CKD patients, reinforcing previously highlighted data in the literature. 18 It is worth mentioning that CKD coding in our database very probably reflects long-standing impaired renal function confirmed by attending physicians, as opposed to reversible renal dysfunction during admission, which is amenable to improve and has been evaluated as a predictive factor in HF by other authors. 19 Our diabetic patients admitted for HF presented with a higher number of established cardiovascular risk factors and coexisting medical conditions.…”