Publication details

Long-term survival following acute heart failure: The Acute Heart Failure Database Main registry (AHEAD Main)

Authors

PAŘENICA Jiří ŠPINAR Jindřich VÍTOVEC Jiří WIDIMSKY Petr LINHART Ales FEDORCO Marian VACLAVIK Jan MIKLÍK Roman FELŠŐCI Marián HOŘÁKOVÁ Kateřina CIHALIK Cestmir MALEK Filip ŠPINAROVÁ Lenka BĚLOHLÁVEK Jan KETTNER Jiří ZEMAN Kamil DUŠEK Ladislav JARKOVSKÝ Jiří

Year of publication 2013
Type Article in Periodical
Magazine / Source European Journal of Internal Medicine
MU Faculty or unit

Faculty of Medicine

Citation
Doi http://dx.doi.org/10.1016/j.ejim.2012.11.005
Field Cardiovascular diseases incl. cardiosurgery
Keywords Acute heart failure; AHEAD; Prognosis
Attached files
Description Background: The in-hospital mortality of patients with acute heart failure (AHF) is reported to be 12.7% and mortality on day 30 after admission 17.2%. Less information is known about the long-term prognosis of those patients discharged after hospitalization. As such, the aim of this study was to investigate long-term survival in a cohort of patients who had been hospitalized for AHF and then discharged. Methods: The AHEAD Main registry includes 4153 patients hospitalized for AHF in 7 different medical centers, each with its own cathlab, in the Czech Republic. Patient survival rates were evaluated in 3438 patients who had survived to day 30 after admission, and were used as a measurement of long-term survival. Results: The most common etiologies were acute coronary syndrome (32.3%) and chronic ischemic heart disease (20.1%). The survival rate after day 30 following admission was 79.7% after 1 year and 64.5% after 3 years. No statistically significant difference in syndromes was found in survival after day 30. Independent predictors of a worse prognosis were defined as follows: age > 70 years, comorbidities, severe left ventricular systolic dysfunction, valvular disease or ACS as an etiology of AHF. A better prognosis was defined for de-novo AHF patients, and those who were taking ACE inhibitors at the time of discharge. In a sub-analysis, high levels of natriuretic peptides were the most powerful predictors of high-risk, long-term mortality. Conclusion: The AHEAD Main registry provides up-to-date information on the long-term prognosis of patients hospitalized with AHF. The 3-year survival of patients following day 30 of admission was 64.5%. Higher age, LV dysfunction, comorbidities and high levels of natriuretic peptides were the most powerful predictors of worse prognosis in long-term survival.

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