Shoaib, A, Farag, M, Nolan, J, Rigby, A, Patwala, A, Rashid, M, Kwok, CS, Perveen, R, Clark, AL, Komajda, M and Cleland, JGF (2019) Mode of presentation and mortality amongst patients hospitalized with heart failure?: a report from The First Euro Heart Failure Survey. Clinical Research in Cardiology, 108 (5). pp. 510-519. ISSN 0300-5860

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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.

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.

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.

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 - 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: 10 Jun 2019 10:19

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