Tachycardia and Pre-existing Chronic Kidney Disease Are Predictors of the Worse Clinical Outcomes in Patients Recently Hospitalized With Acute Heart Failure

Abstract

Background: This study aimed to assess the factors contributing to the outcomes of recently hospitalized patients with heart failure (HF).Methods: A prospective data of 76 adults who were admitted due to acute HF between October 1, 2019 and June 30, 2020 at our center were analyzed. Endpoints included survival and rehospitalization within six months after discharge.Results: The mean age was 64.9 ± 13.8 years, with a male preponderance (68.4%). Approximately 60.5% of patients had the left ventricular ejection fraction (LVEF) <40%, whereas 26.3% of patients had LVEF ≥50%. Coronary artery disease (75%), arterial hypertension (72.4%), chronic kidney disease (46.1%), and diabetes mellitus (46.1%) were the most frequent comorbidities. Poor compliance (40.8%) and non-cardiac infection (21.1%) were the common precipitating factors for hospitalization. The majority of subjects had severe symptoms, indicated by the frequent need of intensive care unit (43%), high N-terminal prohormone brain natriuretic peptide levels [NT-proBNP; median, 4765 (1539.7-11782.2) pg/mL], and presence of either atrial fibrillation, severe mitral regurgitation, or significant pulmonary hypertension in approximately one-third of cases. Even though in-hospital mortality was relatively low (2.6%), the all-cause mortality and rehospitalization rates in the next six months after discharge were still high, reaching 22.54% and 19.72%, respectively. Further survival analysis showed that tachycardia on admission and pre-existing chronic kidney disease (CKD) resulted in low six-month survival rates among these patients. Conclusion:After hospital discharge, patients with HF were still exposed to higher risks of death and readmission albeit with the medication addressed. Tachycardia on admission and pre-existing CKD might predict worse outcomes.

Prediction of the Development of Acute Heart Failure of High Grades in Patients with Myocardial Infarction and Percutaneous Coronary Intervention

“…Переважно це старший вік пацієнтів, жіноча стать [9,10,11], передня локалізація ІМ та багатосудинне ураження коронарного русла [12,13]. Велике прогностичне значення надається і супутній патології -артеріальній гіпертензії, гіперглікемії, наявності фібриляції передсердь, хронічній хворобі нирок, зниженню рівня гемоглобіну [4,11,14,15,16], що можна пояснити патогенетичним впливом таких станів. Водночас дослідження вказують на більш широке застосування реваскуляризації у пацієнтів з ІМ, ускладненим кардіогенним шоком, та зниження смертності у такій групі пацієнтів з 52 до 25 % [17].…”