Acute heart failure: clinical presentation, one-year mortality and prognostic factors.
OBJECTIVE
Acute heart failure (HF) is a common but ill-defined clinical entity. We describe patients hospitalised with acute HF in regard of clinical presentation, mortality, and risk factors for an unfavourable outcome.


RESULTS
We conducted a prospective study including 312 consecutive patients from two European centers hospitalised with acute HF, defined as new onset or worsening of symptoms and signs of HF within 7 days. The mean age was 73 years and 56% were men. Twenty-eight percent had de-novo acute HF and 72% a decompensation of chronic HF. Coronary heart disease (CHD) was the most frequent underlying heart disease, elevated blood pressure >150 mmHg and acute ischemia being the most important triggers. Four percent of the patients had cardiogenic shock, 13% presented with pulmonary edema. LV-EF was <35%, 35-50% and >50% in 35%, 32% and 33% of the patients, respectively. ICU-treatment was necessary in 39% of the patients. Thirty-day mortality (11%) was increased in the presence of shock or elevated troponin T levels. Twelve-month all-cause mortality (29%) increased in the presence of shock, left ventricular dysfunction, renal insufficiency, CHD, and age.


CONCLUSIONS
This prospective study shows that despite modern treatment, morbidity and mortality of patients hospitalised with acute HF remain high.
Rudiger
Alain
A
Department of Medicine, University Hospital Zürich, Switzerland. arudiger99@yahoo.de
Harjola
Veli-Pekka
VP
Müller
Andreas
A
Mattila
Eero
E
Säila
Petrus
P
Nieminen
Markku
M
Follath
Ferenc
F
D000208:Acute Disease; D000368:Aged; D015897:Comorbidity; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality* / Q000503:physiopathology; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D013318:Stroke Volume; D014336:Troponin / Q000097:blood; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology
D014336:Troponin