Demographics, clinical characteristics, and outcomes of patients hospitalized for decompensated heart failure: observations from the IMPACT-HF registry.
BACKGROUND
Hospitalizations for decompensated heart failure are frequent. The Initiation Management Pre-discharge Assessment of Carvedilol Heart Failure (IMPACT-HF) registry collected observational data in patients hospitalized for worsening heart failure to characterize an unselected group of patients and to confirm the generalizability of the IMPACT-HF main trial population.


RESULTS
The IMPACT-HF registry was conducted concurrently with the IMPACT-HF study, a randomized trial of in-hospital initiation of carvedilol compared with the standard practice of postdischarge beta-blocker initiation. Patients were eligible for registry enrollment if they were hospitalized for heart failure regardless of ejection fraction. There were no exclusions to participation. Patients were followed for 60 days. The IMPACT-HF Registry enrolled 567 patients. The mean age was 71 years, 52% of the patients were men and 82% were Caucasian. At discharge, 71% received an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, 41% received digoxin, and 62% received beta-blockers. The 60-day rate of rehospitalization or death was 31%.


CONCLUSIONS
The IMPACT-HF registry enrolled elderly patients admitted for worsening heart failure primarily resulting from progressive volume overload. The 60-day rate of death or rehospitalization was high despite the use of evidence-based therapies. New treatments for this population are needed to decrease the morbidity and mortality associated with decompensated heart failure.
O'Connor
Christopher M
CM
Department of Medicine, Division of Cardiology, Duke University Medical Center and Clinical Research Institute, 2400 N. Pratt Street, Durham, NC 27705, USA.
Stough
Wendy Gattis
WG
Gallup
Dianne S
DS
Hasselblad
Vic
V
Gheorghiade
Mihai
M
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000367:Age Factors; D000368:Aged; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D015897:Comorbidity; D005260:Female; D006333:Heart Failure / Q000453:epidemiology* / Q000628:therapy*; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009566:Nitrates / Q000627:therapeutic use; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge; D010359:Patient Readmission; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012042:Registries; D014481:United States / Q000453:epidemiology
D000319:Adrenergic beta-Antagonists; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D009566:Nitrates