title: Implications of a History of Syncope in Patients Hospitalized With Heart Failure.
abstract: We assessed the frequency and implications of a history of syncope of up to 1 year prior to hospitalization with acute heart failure (AHF) between February and November 2012. Data were collected for 5005 patients hospitalized with AHF and analyzed and compared according to the absence/presence of a history of syncope (group 1 vs group 2). Prior syncope among patients with heart failure was 5.3%. Age, gender, hypertension, atrial fibrillation, bundle branch block, left ventricular ejection fraction (LVEF), and obstructed coronary vessels were comparable in the 2 groups. Group 2 patients were more likely to smoke or have diabetes mellitus, stroke, and cardiac arrest. Group 2 patients frequently required aggressive treatment and had more worse in-hospital and 1-year outcomes compared to group 1. After adjustment for age, sex, ethnicity, and LVEF, multivariate regression analysis showed that history of syncope predicted in-hospital mortality (odds ratio: 2.61; 95% confidence interval: 1.707-4.002). History of syncope during the year prior to the index admission with AHF is a marker of worse outcomes regardless of patient age and LVEF. Further studies are required to confirm this observation and its clinical implications.
authors.affiliation: 1 Clinical Medicine, Weill Cornel Medical College, Doha, Qatar.|2 Clinical Research, Hamad General Hospital, Doha, Qatar.
authors.forename: Ayman
authors.initials: A
authors.lastname: El-Menyar
authors.affiliation: 3 Department of Cardiology, Royal Hospital, Muscat, Oman.
authors.forename: Kadhim
authors.initials: K
authors.lastname: Sulaiman
authors.affiliation: 4 Cardiology Department, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Ali
authors.initials: A
authors.lastname: AlSadawi
authors.affiliation: 5 Institute of Cardiac Sciences, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates.
authors.forename: Alawi A
authors.initials: AA
authors.lastname: AlSheikh-Ali
authors.affiliation: 6 Cardiology, Cleveland Clinic, Abu Dhabi, United Arab Emirates.
authors.forename: Wael
authors.initials: W
authors.lastname: AlMahameed
authors.affiliation: 7 Department of Cardiology, Dubai Hospital, Dubai, United Arab Emirates.
authors.forename: Nooshin
authors.initials: N
authors.lastname: Bazargani
authors.affiliation: 8 Department of Cardiology, Faculty of Medicine, Sana'a University, Sana'a, Yemen.
authors.forename: Ahmed
authors.initials: A
authors.lastname: AlMotarreb
authors.affiliation: 9 Department of Cardiology, Mohammed Bin Khalifa Cardiac Center, Manamah, Bahrain.
authors.forename: Haitham
authors.initials: H
authors.lastname: Amin
authors.affiliation: 4 Cardiology Department, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Nidal
authors.initials: N
authors.lastname: Asaad
authors.affiliation: 10 Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Khalid
authors.initials: K
authors.lastname: Al Habib
authors.affiliation: 11 Department of Cardiology, Adan Hospital, Hadiya, Kuwait.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Ridha
authors.affiliation: 12 Department of Cardiology, Sabah Al-Ahmed Cardiac Center, Kuwait.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Al-Jarallah
authors.affiliation: 13 Vascular Surgery, Hamad General Hospital, Doha, Qatar.
authors.forename: Hassan
authors.initials: H
authors.lastname: Al-Thani
authors.affiliation: 10 Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Husam
authors.initials: H
authors.lastname: AlFaleh
authors.affiliation: 4 Cardiology Department, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Rajvir
authors.initials: R
authors.lastname: Singh
authors.affiliation: 3 Department of Cardiology, Royal Hospital, Muscat, Oman.
authors.forename: Prashanth
authors.initials: P
authors.lastname: Panduranga
authors.affiliation: 4 Cardiology Department, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Jassim
authors.initials: J
authors.lastname: Al Suwaidi
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D015897:Comorbidity; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000208:ethnology / Q000401:mortality / Q000503:physiopathology*; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D008019:Life Style / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D008877:Middle East / Q000453:epidemiology; D011379:Prognosis; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D013575:Syncope / Q000175:diagnosis / Q000208:ethnology / Q000401:mortality / Q000503:physiopathology*; D013997:Time Factors
keywords: heart failure; morbidity; mortality; presentation; syncope