Shoaib, A, Farag, M, Nolan, J, Rigby, A, Patwala, A, Rashid, M, Kwok, CS ORCID: 0000-0001-7047-1586, Perveen, R, Clark, AL, Komajda, M and Cleland, JGF (2018) Mode of presentation and mortality amongst patients hospitalized with heart failure?: a report from The First Euro Heart Failure Survey. Clinical Research in Cardiology. ISSN 0300-5860

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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 The 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.

Item Type: Article
Additional Information: This is the final published version of the article (version of record). It first appeared online via Springer at http://doi.org/10.1007/s00392-018-1380-6 - please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords: acute heart failure, Presentation of heart failure, mortality
Subjects: R Medicine > RC Internal medicine > RC666 Diseases of the circulatory (Cardiovascular) system
Divisions: Faculty of Medicine and Health Sciences > Institute for Applied Clinical Sciences
Depositing User: Symplectic
Date Deposited: 01 Nov 2018 14:17
Last Modified: 01 Nov 2018 14:20
URI: http://eprints.keele.ac.uk/id/eprint/5471

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