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Predictors of short term mortality in heart failure - insights from the Euro Heart Failure survey

Velavan, Periaswamy; Khan, Nasrin K.; Goode, Kevin; Rigby, Alan S.; Loh, Poay H.; Komajda, Michel; Follath, Ferenc; Swedberg, Karl; Madeira, Hugo; Cleland, John G.F.

Authors

Periaswamy Velavan

Nasrin K. Khan

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Dr Kevin Goode K.M.Goode@hull.ac.uk
Research Systems Project Manager / Business Analyst

Alan S. Rigby A.Rigby@hull.ac.uk

Poay H. Loh

Michel Komajda

Ferenc Follath

Karl Swedberg

Hugo Madeira

John G.F. Cleland



Abstract

Objective: To identify factors associated with short term mortality in hospitalised patients with heart failure. Background: Hospitalisation is frequent in patients with heart failure and is associated with a high mortality. Methods: The Euro Heart Failure survey collected data from patients with suspected heart failure. We searched this data for predictors of short term mortality. Results: Of 10,701 patients, 1404 (13%) died within 12 weeks of admission. On univariate analysis, increasing age, hyponatraemia, renal impairment, hyperkalaemia, anaemia, severe mitral regurgitation, severe LV systolic dysfunction(LVSD), increasing QRS and female sex carried adverse prognosis. ACEI, beta-blockers, nitrates, anti-thrombotic and lipid lowering drugs were associated with a better prognosis. On multivariable analysis the following provided independent prognostic information: increasing age (OR per SD=1.5, 95% CI 1.4-1.6), severe LVSD (1.8, 1.5-2.1), serum creatinine (1.2, 1.2-1.3), sodium (0.9, 0.8-0.9), Hb (0.9, 0.8-0.9) and treatment with ACEI (0.5, 0.5-0.6), beta-blockers (0.7, 0.6-0.8), statins (0.6, 0.5-0.7), calcium channel blockers (0.7, 0.6-0.8), warfarin (0.5, 0.4-0.6), heparin (1.7, 1.4-1.9), antiplatelet drugs (0.6, 0.5-0.6) and need for inotropes (5.5, 4.6-6.6). A simple risk score (range 0-11) identified cohorts with a 12 week mortality ranging from 2% to 44%. Conclusions: Simple and readily available clinical variables and a risk score based on medical history and routine tests that all patients admitted with heart failure have, can identify patients with good, intermediate and high short term mortality. (C) 2008 Elsevier Ireland Ltd. All rights reserved.

Journal Article Type Article
Publication Date Jan 7, 2010
Journal INTERNATIONAL JOURNAL OF CARDIOLOGY
Print ISSN 0167-5273
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 138
Issue 1
Pages 63-69
APA6 Citation Velavan, P., Khan, N. K., Goode, K., Rigby, A. S., Loh, P. H., Komajda, M., …Cleland, J. G. (2010). Predictors of short term mortality in heart failure - insights from the Euro Heart Failure survey. International journal of cardiology, 138(1), 63-69. https://doi.org/10.1016/j.ijcard.2008.08.004
DOI https://doi.org/10.1016/j.ijcard.2008.08.004
Keywords Heart failure; Mortality; Cholesterol; Risk score; Euro Heart Failure survey
Publisher URL https://www.sciencedirect.com/science/article/pii/S0167527308009509?via%3Dihub#!
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