Mode of presentation and mortality amongst patients hospitalized with heart failure? A report from the First Euro Heart Failure Survey
Shoaib, A.; Farag, M.; Nolan, J.; Rigby, A.; Patwala, A.; Rashid, M.; Kwok, C. S.; Perveen, R.; Clark, A.; Komajda, M.; Cleland, J. G.F.
C. S. Kwok
J. G.F. Cleland
© 2018, The Author(s). 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%), 2479 (24%), 1040 (10%), 703 (7%), and 4691 (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.
|Journal Article Type||Article|
|Peer Reviewed||Peer Reviewed|
|APA6 Citation||Shoaib, A., Farag, M., Nolan, J., Rigby, A., Patwala, A., Rashid, M., …Cleland, J. G. (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), 510-519. https://doi.org/10.1007/s00392-018-1380-6|
|Keywords||Acute heart failure; Presentation of heart failure; Mortality|
© The Author(s) 2018
This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.