title: Baseline characteristics and hospital mortality in the Acute Heart Failure Database (AHEAD) Main registry.
abstract: BACKGROUND
  The prognosis of patients hospitalized with acute heart failure (AHF) is poor and risk stratification may help clinicians guide care. The objectives of the Acute Heart Failure Database (AHEAD) registry are to assess patient characteristics, etiology, treatment and outcome of AHF.
  
  
  METHODS
  The AHEAD main registry includes patients hospitalized for AHF in seven centers with a Catheterization Laboratory Service in the Czech Republic. The data were collected from September 2006 to October 2009. The inclusion criteria for the database adhere to the European guidelines for AHF (2005) and patients were systematically classified according to the basic syndromes, type and etiology of AHF.
  
  
  RESULTS
  Of 4,153 patients, 12.7% died during hospitalization. The median length of hospitalization was 7.1 days. Mean age of patients was 71.5 ± 12.4 years; men were younger (68.6 ± 12.4 years) compared to women (75.5 ± 11.5 years) (P < 0.001). De-novo heart failure was seen in 58.3% of the patients. According to the classification of heart failure syndromes, acute decompensated heart failure (ADHF) was reported in 55.3%, hypertensive AHF in 4.4%, pulmonary edema in 18.4%, cardiogenic shock in 14.7%, high output failure in 3.3%, and right heart failure in 3.8%. The mortality of cardiogenic shock was 62.7%, of right AHF 16.7%, of pulmonary edema 7.1%, of high output HF 6.1%, whereas the mortality of hypertensive AHF or ADHF was < 2.5%. According to multivariate analyses, low systolic blood pressure, low cholesterol level, hyponatremia, hyperkalemia, the use of inotropic agents and norepinephrine were predictive parameters for in-hospital mortality in patients without cardiogenic shock. Severe left ventricular dysfunction and renal insufficiency were predictive parameters for mortality in patients with cardiogenic shock. Invasive ventilation and age over 70 years were the most important predictive factors for mortality in both genders with or without cardiogenic shock.
  
  
  CONCLUSIONS
  The AHEAD Main registry provides up-to-date information on the etiology, treatment and hospital outcomes of patients hospitalized with AHF. The results highlight the highest risk patients.
authors.affiliation: Department of Internal Cardiology Medicine, University Hospital Brno, Jihlavska 20, Brno 625 00, Czech Republic.
authors.forename: Jindrich
authors.initials: J
authors.lastname: Spinar
authors.forename: Jiri
authors.initials: J
authors.lastname: Parenica
authors.forename: Jiri
authors.initials: J
authors.lastname: Vitovec
authors.forename: Petr
authors.initials: P
authors.lastname: Widimsky
authors.forename: Ales
authors.initials: A
authors.lastname: Linhart
authors.forename: Marian
authors.initials: M
authors.lastname: Fedorco
authors.forename: Filip
authors.initials: F
authors.lastname: Malek
authors.forename: Cestmír
authors.initials: C
authors.lastname: Cihalik
authors.forename: Lenka
authors.initials: L
authors.lastname: Spinarová
authors.forename: Roman
authors.initials: R
authors.lastname: Miklik
authors.forename: Marian
authors.initials: M
authors.lastname: Felsoci
authors.forename: Miroslav
authors.initials: M
authors.lastname: Bambuch
authors.forename: Ladislav
authors.initials: L
authors.lastname: Dusek
authors.forename: Jiri
authors.initials: J
authors.lastname: Jarkovsky
mesh_terms: D000208:Acute Disease; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography / Q000706:statistics & numerical data; D005260:Female; D006333:Heart Failure / Q000209:etiology / Q000401:mortality* / Q000628:therapy; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012042:Registries / Q000706:statistics & numerical data; D012307:Risk Factors; D012737:Sex Factors; D018709:Statistics, Nonparametric