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Mode of presentation and mortality amongst patients hospitalized with heart failure?: a report from The First Euro Heart Failure Survey

Shoaib, Ahmad; Farag, M.; Nolan, J.; Rigby, A.; Patwala, A.; Rashid, M.; Kwok, C.S.; Perveen, R.; Clark, A.L.; Komajda, M.; Cleland, J.G.F.

Mode of presentation and mortality amongst patients hospitalized with heart failure?: a report from The First Euro Heart Failure Survey Thumbnail


Authors

Ahmad Shoaib

M. Farag

A. Rigby

A. Patwala

C.S. Kwok

R. Perveen

A.L. Clark

M. Komajda

J.G.F. Cleland



Abstract

Background:
Heart failure is heterogeneous in aetiology, pathophysiology and presentation. Despite this diversity, clinical trials of patients hospitalized for HF deal with this problem as a single entity, which may be one reason for repeated failures.

Methods:
First EuroHeart Failure Survey screened consecutive deaths and discharges of patients with suspected heart failure during 2000-2001. Patients were sorted into seven mutually exclusive hierarchical presentations: 1) with cardiac arrest/ ventricular arrhythmia; 2): with acute coronary syndrome; 3) with rapid atrial fibrillation; 4) with acute breathlessness; 5) with other symptoms/signs such as peripheral oedema ; 6) with stable symptoms and 7) others in whom the contribution of HF to admission was not clear.

Results:
The 10,701 patients enrolled were classified into the above seven presentations as follows:- 260 (2%), 560 (5%), 799 (8%), 2,479 (24%), 1,040 (10%), 703 (7%), and 4,691 (45%) for which index-admission mortality was 26%, 20%, 10%, 8%, 6%, 6% and 4% respectively. Compared to those in group 7, the hazard ratios for death during the index admission were 4.9 (p= <0.001), 4.0 (p<0.001), 2.2 (p<0.001), 2.1 (p<0.001), 1.4 (p<0.04) and 1.4 (p=0.04) respectively. These differences were no longer statistically significant by 12 weeks.

Conclusion:
There is great diversity in the presentation of heart failure that is associated with very different short-term outcomes. Only a minority of hospitalizations associated with suspected heart failure are associated with acute breathlessness. This should be taken into account in the design of future clinical trials. Key words: Acute heart failure, Presentation of Heart failure, Mortality.

Journal Article Type Article
Acceptance Date Oct 11, 2018
Publication Date May 1, 2019
Publicly Available Date Mar 29, 2024
Journal Clinical Research in Cardiology
Print ISSN 0300-5860
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 108
Pages 510-519
DOI https://doi.org/10.1007/s00392-018-1380-6
Keywords acute heart failure, Presentation of heart failure, mortality
Publisher URL http://doi.org/10.1007/s00392-018-1380-6

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