Ten-year survival and prognostic markers in one thousand patients with advanced heart failure. A single-centre analysis.
OBJECTIVE
Patients with advanced heart failure (HF) represent a pool of candidates for heart transplantation and long-term mechanical circulatory support devices. The aim of our study was to determine simple and reliable markers of one-year mortality for selection of the most suitable patients for heart replacement therapy.


RESULTS
One thousand consecutive patients with HF (mean age 49 ± 10.9 years; 86.8% males) referred to a single tertiary centre from January 1998 to January 2010 in order to assess the indication for heart transplantation were enrolled. Kaplan-Meier survival analysis was performed. Independent mortality predictors were established using logistic regression analysis. The mean follow-up was 4.3 ± 2.7 years (range 1-12 years). Cumulative survival was as follows: 1-year survival 83%, 3-year 63%, 5-year 50%, 7-year 39%, and 10-year 23%. Independent predictors of 1-year mortality included coronary artery disease, left ventricular diastolic diameter >79 mm, plasma sodium <135 mmol/L, the need for intravenous treatment at hospital admission (diuretics and/or inotropes), and furosemide dose at discharge >240 mg/day.


CONCLUSIONS
Short-term prognosis of HF patient can be estimated based on simple parameters. Patients with signs of poor prognosis should be referred to tertiary centres to be considered for heart replacement therapy.
Heart Failure and Transplant Department, National Cardiovascular Institute, Bratislava, Slovak Republic.
Peter
P
Lesny
Heart Failure and Transplant Department, National Cardiovascular Institute, Bratislava, Slovak Republic.
Milan
M
Luknar
Adolescent Clinic, Dunajska Luzna, Slovak Republic.
Martin
M
Matejka
Heart Failure and Transplant Department, National Cardiovascular Institute, Bratislava, Slovak Republic.
Ivan
I
Varga
Heart Failure and Transplant Department, National Cardiovascular Institute, Bratislava, Slovak Republic.
Peter
P
Solik
Slovak Medical University, Bratislava, Slovak Republic.
Sona
S
Wimmerova
Heart Failure and Transplant Department, National Cardiovascular Institute, Bratislava, Slovak Republic.
Eva
E
Goncalvesova
D015415:Biomarkers / Q000378:metabolism; D005260:Female; D006333:Heart Failure / Q000401:mortality*; D016027:Heart Transplantation / Q000401:mortality*; D006353:Heart-Assist Devices; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011379:Prognosis; D012307:Risk Factors
D015415:Biomarkers
heart failure; heart transplantation; mechanical circulatory support; survival prognosis