Worsening heart failure associated with poor long-term prognosis
Click Here to Manage Email Alerts
In patients with HF with reduced ejection fraction, worsening HF, defined as HF hospitalization or urgent need for IV diuretics, was independently associated with poor long-term prognosis, researchers reported.
The researchers concluded that novel HF treatments should be considered after a first episode of worsening HF to improve prognosis.
Source: Adobe Stock
The study included 1,801 patients with HFrEF (mean age, 64 years; 74% men). The primary outcome was all-cause mortality.
At a median follow-up of 20 months, worsening HF occurred in 15% of patients, according to the researchers, who noted that compared with those who did not have worsening HF, those who did had higher prevalence of family history of CAD (27% vs. 18%, P = .004), PCI (35% vs. 27%; P = .01), MI (49% vs. 39%; P = .01), implantable cardioverter defibrillator use (51% vs. 31%; P < .001) and cardiac resynchronization therapy use (29% vs. 17%; P < .001).
At a median of 60 months, 24% of patients died, and the mortality rate was higher in patients with worsening HF compared with patients without worsening HF (37% vs. 23%; log-rank P < .0001), Surenjav Chimed, MD, from the department of cardiology, Heart Lung Center, Leiden University Medical Center in the Netherlands, and colleagues wrote.
When the researchers adjusted for clinical and echocardiographic parameters, they found worsening HF was independently associated with elevated risk for all-cause mortality during the study period (HR = 1.46; 95% CI, 1.09-1.96), and in an analysis of a landmark time of 24 months (HR = 1.68; 95% CI, 1.22-2.3).
Worsening HF was associated with 60-month mortality in patients with left ventricular ejection fraction of 25% or less (log-rank P < .0001) and LVEF 26% to 34% (log-rank P = .038) but not in patients with LVEF 35% to 45% (log-rank P = .14), the researchers wrote.
“Worsening HF is associated with higher long-term mortality, and therefore it is reasonable to consider the early initiation of intensive HF treatment for this high-risk patient population,” Chimed and colleagues wrote.
Collapse
Read more about
Click Here to Manage Email Alerts