De novo acute heart failure: Clinical features and one-year mortality in the Spanish nationwide Registry of Acute Heart Failure
Por:
Franco, J, Formiga, F, Corbella, X, Conde-Martel, A, Llacer, P, Rocha, P, Gorricho, G, Satue, J, Rangel, L, Manzano, L, Montero-Perez-Barquero, M, Anarte, L, Aramburu, O, Arevalo-Lorido, J, Carrascosa, S, Carrera, M, Cepeda, J, Cerqueiro, J, Davila, M, Diez-Manglano, J, Epelde, F, Franco, J, Garcia-Escriva, D, Franco, A, Lopez-Castellanos, G, Manzano, L, Montero-Perez-Barquero, M, Muela, A, Perez-Silvestre, J, Quesada, M, Roca, B, Ruiz-Ortega, R, Satue, J, Soler-Rangel, L, Trullas, J and Grp Invest RICA
Publicada:
15 feb 2019
Categoría:
Medicine (miscellaneous)
Resumen:
Introduction and objectives: Acute heart failure (AHF), can occur as decompensated chronic heart failure (HF) or as a first episode, "new onset". The aim of this study was to analyse the clinical characteristics and prognosis at one-year in a cohort of patients with new onset AHF.
Methods: Prospective observational study of 3,550 patients with AHF. We compared patients with new onset HF with the others. Restricting the analysis to new onset AHF patients, we analysed the clinical characteristics, readmissions, mortality and impact of left ventricular ejection fraction on the prognosis.
Results: A total of 1,105 (31%) patients fulfil the criteria for new onset AHF. These patients versus the rest, were younger, had a higher aetiology of hypertension and preserved left ventricular ejection fraction, less global comorbidity and better baseline overall functional status. After one year, mortality in new onset HF was less than chronic decompensated HF (15 vs. 27%; p<.001; respectively). Multivariate analysis showed a correlation between mortality and higher global comorbidity (hazard ratio. -HR- 1.11), renal failure (HR 1.73), higher prescription of antialdosteronics and antiaggregant (HR 2.13; 1.8; respectively). Left ventricular ejection fraction was unrelated to mortality.
Conclusions: New onset AHF shows a clinical profile and prognosis different to that of chronic decompensated HF. Higher comorbidity, renal function and treatment post-discharge predict a higher risk of mortality. (C) 2018 Elsevier Espafia, S.L.U. All rights reserved.
Filiaciones:
Franco, J:
Hosp Univ Quiron Dexeus, Dept Med Interna, Barcelona, Spain
Formiga, F:
Hosp Univ Bellvitge, Hosp Llobregat, Dept Med Interna, Barcelona, Spain
Corbella, X:
Hosp Univ Bellvitge, Hosp Llobregat, Dept Med Interna, Barcelona, Spain
Univ Int Catalunya, Fac Med & Ciencias Salud, Catedra Hestia Atenc Social & Sanitaria, Barcelona, Spain
Conde-Martel, A:
Hosp Univ Dr Negrin, Dept Med Interna, Las Palmas Gran Canaria, Gran Canaria, Spain
Llacer, P:
Hosp Manises, Dept Med Interna, Valencia, Spain
Rocha, P:
Hosp Clin Dr Manuel Quintela, Unidad Multidisciplinaria Insuficiencia Cardiaca, Montevideo, Uruguay
Gorricho, G:
Hosp Clin Dr Manuel Quintela, Unidad Multidisciplinaria Insuficiencia Cardiaca, Montevideo, Uruguay
Satue, J:
Hosp Univ Fuenlabrada, Dept Med Interna, Fuenlabrada, Spain
Rangel, L:
Hosp Univ Infanta Sofia, Dept Med Interna, Madrid, Spain
Manzano, L:
Univ Alcala IRYCIS, Hosp Univ Raman y Cajal, Dept Med Interna, Madrid, Spain
Montero-Perez-Barquero, M:
Univ Cordoba, Hosp Univ Reina Sofia, Dept Med Interna, Cordoba, Spain
Franco, J:
Hosp Univ Quiron Dexeus, Dept Med Interna, Barcelona, Spain
Manzano, L:
Univ Alcala IRYCIS, Hosp Univ Raman y Cajal, Dept Med Interna, Madrid, Spain
Montero-Perez-Barquero, M:
Univ Cordoba, Hosp Univ Reina Sofia, Dept Med Interna, Cordoba, Spain
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