European Heart Journal Advance Access originally published online on November 24, 2006
European Heart Journal 2006 27(24):3011-3017; doi:10.1093/eurheartj/ehl407
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Characteristics, outcomes, and predictors of 1-year mortality in patients hospitalized for acute heart failure
1 Division of Cardiology, Department of Medicine, Helsinki, University Central Hospital, Helsinki, Finland
2 Department of Medicine, Central Finland Central Hospital, Jyväskylä, Finland
3 Department of Cardiology, Kuopio University Hospital, Kuopio, Finland
4 Division of Emergency Care, Department of Medicine, Helsinki, University Central Hospital, PO Box 340, 00029 HUS, Helsinki, Finland
Received 31 March 2006; revised 11 October 2006; accepted 6 November 2006; online publish-ahead-of-print 24 November 2006.
* Corresponding author. Tel: +358 50 427 1372; fax: +358 9 4717 4125. E-mail address: veli-pekka.harjola{at}hus.fi
Aims Acute heart failure (AHF) is associated with poor prognosis and requires recurrent hospitalizations. However, studies on AHF characteristics, treatment, and prognostic factors are few. Our aim was to investigate the characteristics, treatment, and 1-year prognosis of AHF and identify prognostic factors in different clinical groups.
Methods and results We conducted a prospective multicentre study with 620 patients hospitalized due to AHF; mean age 75.1 (10.4) years, 50% male. Half of the patients had new-onset heart failure. Acute congestion (63.5%) and pulmonary oedema (26.3%) were the most common clinical presentations. Left ventricular ejection fraction (LVEF) was reported in two-thirds of patients. Half of these had preserved systolic function (LVEF
45%). At discharge, 86% of patients had beta-blockers and 76% either ACE-inhibitors or angiotensin receptor blockers in use. The 12-month all-cause mortality was 27.4%. We identified several clinical and biochemical prognostic risk factors in univariate analysis. Independent predictors of 1-year mortality were older age, male gender, lower systolic blood pressure (SBP) on admission, C-reactive protein, and serum creatinine >120 µmol/L.
Conclusion We present the characteristics and prognosis of an unselected population of AHF patients. One-year mortality is high, and independent clinical risk factors include age, male gender, lower SBP on admission, C-reactive protein, and renal dysfunction.
Key Words: Acute heart failure • Multicentre study • Decompensated chronic heart failure • New-onset heart failure • De novo heart failure • Risk markers
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