Predictors of long-term survival in patients with a first episode of acute heart failure
Por:
Romero-Carrete, C, Alquézar-Arbé, A, Núñez, J, Gil, V, Jacob, J, Aguirre, A, Jimenez, AV, Borja-Cano, M, de la Espriella, R, Santas, E, Sánchez, C, Repullo, D, Fuentes, L, Bustos, SA, Miñana, G, Llorens, P, Miró, O
Publicada:
1 ene 2025
Resumen:
Introduction: Acute heart failure (AHF) represents a critical event in heart failure progression, but data on long-term outcomes after first hospitalization remain scarce. The aim is to describe longterm survival and evaluate its predictors after the first episode of AHF. Material and methods: Patients from five Spanish hospitals with a confirmed first diagnosis of AHF were categorized based on survival (>= 5 or <5 years).Thirteen independent variables were identified. Mortality was assessed using Kaplan-Meier curves after up to 10 years of follow-up. Adjusted odds ratios (OR) with 95% confidence intervals (CI) for mortality were calculated. Additionally, adjusted survival probabilities according to patient age and left ventricular ejection fraction (LVEF) were obtained using restricted cubic splines. Results: A total of 1986 patients were included, with a median age 76 years (range: 68-82), 50% women, and 57% with preserved LVEF. Five-year mortality was 52%. Adjusted analysis showed that age (OR, 0.470 per 10-year increment; 95% CI, 0.421-0.525), New York Heart Association class III-IV vs. I (OR, 0.476; 95% CI, 0.341-0.666) and II vs. I (OR, 0.780; 95% CI, 0.627-0.969), chronic kidney disease (OR, 0.609; 95% CI, 0.452-0.820), coronary artery disease (OR, 0.657; 95% CI, 0.523-0.824), diabetes mellitus (OR, 0.658; 95% CI, 0.534-0.811), and male sex (OR, 0.774; 95% CI, 0.625-0.958) were associated with death within 5 years. LVEF at inclusion was not related to 5-year survival. Conclusions: Survival after a first AHF episode is poor, with age, NewYork Heart Association class, kidneyfunction, coronary artery disease, diabetes, and sex being key predictors of long-term mortality.
Filiaciones:
Romero-Carrete, C:
Hosp Santa Creu I Sant Pau, Emergency Dept, Barcelona, Catalonia, Spain
Alquézar-Arbé, A:
Hosp Santa Creu I Sant Pau, Emergency Dept, Barcelona, Catalonia, Spain
Núñez, J:
Univ Valencia, Hosp Clin Univ Valencia, Cardiol Dept, INCLIVA,CIBER Cardiovasc, Valencia, Spain
Gil, V:
Univ Barcelona, Hosp Clin, Emergency Dept, IDIBAPS, Barcelona, Catalonia, Spain
Jacob, J:
Hosp Bellvitge Princeps Espanya, Emergency Dept, Barcelona, Catalonia, Spain
Aguirre, A:
Hosp Mar, Emergency Dept, Barcelona, Catalonia, Spain
Jimenez, AV:
Hosp Santa Creu I Sant Pau, Emergency Dept, Barcelona, Catalonia, Spain
Borja-Cano, M:
Hosp Santa Creu I Sant Pau, Emergency Dept, Barcelona, Catalonia, Spain
de la Espriella, R:
Univ Valencia, Hosp Clin Univ Valencia, Cardiol Dept, INCLIVA,CIBER Cardiovasc, Valencia, Spain
Santas, E:
Univ Valencia, Hosp Clin Univ Valencia, Cardiol Dept, INCLIVA,CIBER Cardiovasc, Valencia, Spain
Sánchez, C:
Univ Barcelona, Hosp Clin, Emergency Dept, IDIBAPS, Barcelona, Catalonia, Spain
Repullo, D:
Univ Barcelona, Hosp Clin, Emergency Dept, IDIBAPS, Barcelona, Catalonia, Spain
Fuentes, L:
Hosp Bellvitge Princeps Espanya, Emergency Dept, Barcelona, Catalonia, Spain
Bustos, SA:
Hosp Mar, Emergency Dept, Barcelona, Catalonia, Spain
Miñana, G:
Univ Valencia, Hosp Clin Univ Valencia, Cardiol Dept, INCLIVA,CIBER Cardiovasc, Valencia, Spain
Llorens, P:
Univ Miguel Hernandez, Hosp Doctor Balmis, Short Stay Unit & Hospitalizat Home, Emergency Dept,Inst Invest Sanit & Biomed Alicante, Alicante, Spain
Miró, O:
Univ Barcelona, Hosp Clin, Emergency Dept, IDIBAPS, Barcelona, Catalonia, Spain
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