Long-term survival after hospitalization for acute heart failure - Differences in prognosis of acutely decompensated chronic and new-onset acute heart failure

被引:79
作者
Lassus, Johan P. E. [1 ]
Siirila-Waris, Krista [2 ]
Nieminen, Markku S. [2 ]
Tolonen, Jukka [1 ]
Tarvasmaki, Tuukka [1 ]
Peuhkurinen, Keijo [3 ]
Melin, John [4 ]
Pulkki, Kari [5 ,6 ]
Harjola, Veli-Pekka [7 ]
机构
[1] Univ Helsinki, Cent Hosp, Dept Med, Helsinki, Finland
[2] Univ Helsinki, Cent Hosp, Dept Med, Div Cardiol, Helsinki, Finland
[3] Univ Eastern Finland, Dept Med, Kuopio, Finland
[4] Cent Finland Cent Hosp, Jyvaskyla, Finland
[5] Univ Eastern Finland, Eastern Finland Lab Ctr, Kuopio, Finland
[6] Univ Eastern Finland, Dept Clin Chem, Kuopio, Finland
[7] Univ Helsinki, Cent Hosp, Dept Med, Div Emergency Care, Helsinki, Finland
关键词
Acute heart failure; Long-term prognosis; De-novo; ADCHF; Mortality; PRESERVED EJECTION FRACTION; INITIATE LIFESAVING TREATMENT; SYSTOLIC BLOOD-PRESSURE; SUBSEQUENT MORTALITY; ORGANIZED PROGRAM; OPTIMIZE-HF; POPULATION; PREDICTORS; OUTCOMES; GUIDELINES;
D O I
10.1016/j.ijcard.2012.09.128
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims: To analyze the five-year mortality after hospitalization for acute heart failure (AHF) and compare predictors of prognosis in patients with and without a previous history of heart failure. Methods: Patients with AHF (n=620) from the prospective multicenter FINN-AKVA study were classified as acutely decompensated chronic heart failure (ADCHF) or de-novo AHF if no previous history of heart failure was present. Both all-cause mortality during five years of follow-up and prognostic factors were determined. Results: The overall mortality was 60.3% (n=374) at five years. ADCHF was associated with significantly poorer outcome compared to de-novo AHF; five-year mortality rate 75.6% vs. 44.4% (p<0.001). Initially, mortality was high (33.5% in ADCHF and 21.7% in de-novo AHF after 12 months), but in de-novo AHF the annual mortality declined markedly already after the first year. Compared to de-novo AHF, patients with ADCHF had an increased risk of death for several years after the index hospitalization. A previous history of heart failure was an independent predictor of five-year mortality (adjusted hazard ratio 1.8 (95% CI 1.4-2.2; p<0.001). Older age and impaired renal function were associated with adverse long-term prognosis in both ADCHF and de-novo AHF, while higher systolic blood pressure on admission predicted better outcome. Conclusion: The long-term prognosis after hospitalization for AHF is poor, with a significantly different survival observed in patients with de-novo AHF compared to ADCHF. A previous history of heart failure is an independent predictor of five-year mortality. Distinction between ADCHF and de-novo AHF may improve our understanding of patients with AHF. (c) 2012 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:458 / 462
页数:5
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