title: [PAPRICA-2 study: Role of precipitating factor of an acute heart failure episode on intermediate term prognosis].
abstract: OBJECTIVE
  To evaluate the precipitating factors (PF) associated with acute heart failure and their association with medium-term prognosis.
  
  
  METHODS
  Multipurpose prospective study from the EAHFE Registry. We included as PF: infection, rapid atrial fibrillation (RAF), anaemia, hypertensive crisis, non-adherence to diet or drug therapy and non-ST-segment-elevation acute coronary syndrome (NSTEACS). Patients without PF were control group. Hazard ratios (HR) crudes and adjusted for reconsultations and mortality at 90 days were calculated.
  
  
  RESULTS
  3535 patients were included: 28% without and 72% with PF. Patients with RAF (HR 0.67; 95%CI 0.50-0.89) and hypertensive crisis (HR 0.45; 95%CI 0.28-0.72) had less mortality and patients with NSTEACS (HR 1.79; 95%CI 1.19-2.70) had more mortality. Reconsultation was fewer in patients with infection (HR 0.74; 95%CI 0.64-0.85), RAF (HR 0.69; 95%CI 0.58-0.83) and hypertensive crisis (HR 0.71; 95%CI 0.55-0.91). These differences were maintained in all the adjusted models except for hypertensive crisis.
  
  
  CONCLUSIONS
  One PF is identified in 3 out of 4 patients and it may influence medium-term prognosis. At 90 days, NSTEACS and RAF were associated with more and less mortality respectively, and RAF and infection with less probability of reconsultation.
authors: Área de Urgencias, Hospital Clínic, Barcelona. Grupo de investigación «Urgencias: Procesos y Patologías», IDIBAPS, Barcelona, España. Electronic address: omiro@clinic.ub.es.
authors: Òscar
authors: Ò
authors: Miró
authors: Servicio de Urgencias, Hospital del Mar, Barcelona, España.
authors: Alfons
authors: A
authors: Aguirre
authors: Servicio de Urgencias, Hospital Universitario Central de Asturias, Oviedo, España.
authors: Pablo
authors: P
authors: Herrero
authors: Servicio de Urgencias, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España.
authors: Javier
authors: J
authors: Jacob
authors: Servicio de Urgencias, Hospital Clínico San Carlos, Madrid, Instituto de Investigación Sanitaria, Hospital Clínico San Carlos, Madrid, España.
authors: Francisco Javier
authors: FJ
authors: Martín-Sánchez
authors: Servicio de Urgencias Departamentales, Unidad de Corta Estancia y Unidad de Hospitalización a Domicilio, Hospital General de Alicante, Alicante, España.
authors: Pere
authors: P
authors: Llorens
mesh_terms: D054058:Acute Coronary Syndrome / Q000453:epidemiology; D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000453:epidemiology; D001281:Atrial Fibrillation / Q000453:epidemiology; D048909:Diabetes Complications / Q000453:epidemiology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006333:Heart Failure / Q000453:epidemiology* / Q000401:mortality; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007239:Infections / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000453:epidemiology; D008297:Male; D010349:Patient Compliance; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors
keywords: Factores precipitantes; Heart failure; Insuficiencia cardiaca; Precipitating factors; Prognosis; Pronóstico