Prognostic impact of acute decompensated heart failure in patients with heart failure and mildly reduced ejection fraction.
HFmrEF
acute decompensated heart failure
heart failure with mildly reduced ejection fraction
mortality
prognosis
Journal
European heart journal. Acute cardiovascular care
ISSN: 2048-8734
Titre abrégé: Eur Heart J Acute Cardiovasc Care
Pays: England
ID NLM: 101591369
Informations de publication
Date de publication:
10 Nov 2023
10 Nov 2023
Historique:
received:
21
09
2023
revised:
06
11
2023
accepted:
09
11
2023
medline:
11
11
2023
pubmed:
11
11
2023
entrez:
11
11
2023
Statut:
aheadofprint
Résumé
This study sought to determine the prognostic impact of acute decompensated heart failure (ADHF) in patients with heart failure with mildly reduced ejection fraction (HFmrEF). ADHF is a major complication in patients with heart failure (HF), however, the prognostic impact of ADHF in patients with HFmrEF has not yet been clarified. Consecutive patients hospitalized with HFmrEF (i.e., left ventricular ejection fraction 41-49% and signs and/or symptoms of HF) at one medical center were retrospectively included from 2016 to 2022. The prognosis of patients with ADHF was compared to those without (i.e., non-ADHF). The primary endpoint was all-cause mortality at 30 months (median follow-up). Among others, secondary endpoints included in-hospital mortality and HF-related rehospitalization at 30 months. Kaplan-Meier, multivariable Cox proportional regression and propensity-score matched analyses were performed. A total of 2,184 patients with HFmrEF were included with a rate of ADHF of 22.2%. ADHF was associated with a significantly increased risk of all-cause mortality (50% vs 26%; HR = 2.269; 95% CI 1.939-2.656; p = 0.001) and HF-related rehospitalization at 30 months (27% vs. 10%; HR = 3.250; 95% CI 2.565-4.118; p = 0.001), which was still evident after multivariable adjustment and propensity-score matching. Sub-analysis in the ADHF group indicated that previous ADHF during the 12 months prior to the index admission was associated with higher HF-related rehospitalization (41.7% vs. 23.0%; HR = 2.073; 95% CI 1.420-3.027; p = 0.001), but not all-cause mortality at 30 months (p = 0.264). ADHF is common in HFmrEF and independently associated with 30-month all-cause mortality and HF-related rehospitalization.
Sections du résumé
OBJECTIVE
OBJECTIVE
This study sought to determine the prognostic impact of acute decompensated heart failure (ADHF) in patients with heart failure with mildly reduced ejection fraction (HFmrEF).
BACKGROUND
BACKGROUND
ADHF is a major complication in patients with heart failure (HF), however, the prognostic impact of ADHF in patients with HFmrEF has not yet been clarified.
METHODS
METHODS
Consecutive patients hospitalized with HFmrEF (i.e., left ventricular ejection fraction 41-49% and signs and/or symptoms of HF) at one medical center were retrospectively included from 2016 to 2022. The prognosis of patients with ADHF was compared to those without (i.e., non-ADHF). The primary endpoint was all-cause mortality at 30 months (median follow-up). Among others, secondary endpoints included in-hospital mortality and HF-related rehospitalization at 30 months. Kaplan-Meier, multivariable Cox proportional regression and propensity-score matched analyses were performed.
RESULTS
RESULTS
A total of 2,184 patients with HFmrEF were included with a rate of ADHF of 22.2%. ADHF was associated with a significantly increased risk of all-cause mortality (50% vs 26%; HR = 2.269; 95% CI 1.939-2.656; p = 0.001) and HF-related rehospitalization at 30 months (27% vs. 10%; HR = 3.250; 95% CI 2.565-4.118; p = 0.001), which was still evident after multivariable adjustment and propensity-score matching. Sub-analysis in the ADHF group indicated that previous ADHF during the 12 months prior to the index admission was associated with higher HF-related rehospitalization (41.7% vs. 23.0%; HR = 2.073; 95% CI 1.420-3.027; p = 0.001), but not all-cause mortality at 30 months (p = 0.264).
CONCLUSION
CONCLUSIONS
ADHF is common in HFmrEF and independently associated with 30-month all-cause mortality and HF-related rehospitalization.
Identifiants
pubmed: 37950915
pii: 7405445
doi: 10.1093/ehjacc/zuad139
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.