title: Long-term survival following acute heart failure: the Acute Heart Failure Database Main registry (AHEAD Main).
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Internal Medicine, Cardiology Division, University Hospital Brno, Jihlavska 20, Brno 625 00, Czech Republic.
authors.forename: Jiri
authors.initials: J
authors.lastname: Parenica
authors.forename: Jindrich
authors.initials: J
authors.lastname: Spinar
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: Jan
authors.initials: J
authors.lastname: Vaclavik
authors.forename: Roman
authors.initials: R
authors.lastname: Miklik
authors.forename: Marian
authors.initials: M
authors.lastname: Felsoci
authors.forename: Katerina
authors.initials: K
authors.lastname: Horakova
authors.forename: Cestmir
authors.initials: C
authors.lastname: Cihalik
authors.forename: Filip
authors.initials: F
authors.lastname: Malek
authors.forename: Lenka
authors.initials: L
authors.lastname: Spinarova
authors.forename: Jan
authors.initials: J
authors.lastname: Belohlavek
authors.forename: Jiri
authors.initials: J
authors.lastname: Kettner
authors.forename: Kamil
authors.initials: K
authors.lastname: Zeman
authors.forename: Ladislav
authors.initials: L
authors.lastname: Dušek
authors.forename: Jiri
authors.initials: J
authors.lastname: Jarkovsky
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D018153:Czech Republic / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000401:mortality*; D017052:Hospital Mortality / Q000639:trends; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors