Five-year survival of patients with chronic systolic heart failure of ischemic and non-ischemic etiology: analysis of prognostic factors.
BACKGROUND
Despite advances in pharmacotherapy, electrotherapy and interventional treatment, chronic heart failure (HF) is still associated with poor long-term outcome.


OBJECTIVE
To determine the death rate and risk factors in patients with HF of ischemic and non-ischemic etiology in five-year follow-up.


METHODS
Consecutive patients with chronic systolic HF hospitalized in the period 2006-2008 were analyzed retrospectively. Study exclusion criteria were: infections (< 3 months before hospitalization), hemodynamically significant valve disease, advanced chronic kidney disease, liver cirrhosis and neoplastic diseases (< 5 years before hospitalization).


RESULTS
The analysis encompassed 266 patients divided into two groups: Group A, with HF of ischemic etiology (n = 157), and Group B, with HF of non-ischemic etiology (n = 109). Mortality was significantly higher in Group A than in Group B (49% vs. 28.4%, p = 0.001). The independent risk factors for death in Group A were: New York Heart Association (NYHA) class (HR = 1.81; p < 0.001); concentrations of high-sensitivity C-reactive protein (hs-CRP) (HR = 1.01; p < 0.05), fibrinogen (HR = 1.04; p < 0.001) and N-terminal prohormone brain natriuretic peptide (NT-proBNP) (HR = 1.02; p < 0.001); and right ventricular end-diastolic diameter (RVEDd) (HR = 1.07; p < 0.01). In Group B they were age (HR = 1.07; p < 0.05) and NT-proBNP concentration (HR = 1.03; p < 0.001).


CONCLUSIONS
Mortality was significantly lower in Group B than in Group A. The independent risk factors for death in Group B were age and NT-proBNP serum concentration, whilst in Group A they were NYHA class, serum concentrations of hs-CRP, NT-proBNP and fibrinogen, and RVEDd.
Cardiology Department, Regional Specialist Hospital No. 4 in Bytom.
Mateusz
M
Mościński
3 Chair and Clinical Department of Cardiology, Medical University of Silesia, Silesian Center for Heart Diseases, Zabrze.
Bożena
B
Szyguła-Jurkiewicz
Chair and Clinical Department of Cardiac Surgery and Transplantation, Medical University of Silesia, Silesian Center for Heart Diseases, Zabrze.
Michał
M
Zakliczyński
3 Chair and Clinical Department of Cardiology, Medical University of Silesia, Silesian Center for Heart Diseases, Zabrze.
Piotr
P
Rozentryt
Department of Anesthesiology, Intensive Care and Emergency Medicine, Medical University of Silesia, Katowice.
Robert
R
Partyka
Chair and Clinical Department of Cardiac Surgery and Transplantation, Medical University of Silesia, Silesian Center for Heart Diseases, Zabrze.
Marian
M
Zembala
3 Chair and Clinical Department of Cardiology, Medical University of Silesia, Silesian Center for Heart Diseases, Zabrze.
Lech
L
Poloński
chronic systolic heart failure; prognostic factors