title: [Prognostic value of prior heart failure in patients admitted with acute pulmonary thromboembolism].
abstract: OBJECTIVE
  Pulmonary thromboembolism (PTE) is a very common condition with high mortality. Although some scales include heart failure (HF) as a risk factor of PTE, none of them have assessed the contribution of the different kinds of HF, i. e. with reduced or preserved left ventricular ejection fraction (LVEF) to the in-hospital outcome of patients admitted with PTE.
  
  
  METHODS
  A retrospective study assessing a cohort of patients consecutively admitted to hospital with a PTE from 2012-2014. Baseline epidemiological characteristics, treatment during admission and prognostic variables during hospitalization were analyzed. Primary endpoint was defined as hospital mortality for any cause.
  
  
  RESULTS
  A total of 442 patients with PTE were included (88 with prior HF). Patients with a history of HF were older, more frequently had hypertension, diabetes mellitus, chronic kidney or pulmonary disease, cancer, and coronary artery disease, and showed less LVEF (P<.001). Hospital mortality was significantly higher in patients with prior HF (21.6 vs. 6.8%, P<.001). Multivariate analysis found that HF with reduced LVEF but not HF with preserved LVEF resulted as an independent risk factor (respectively OR 5.54; 95% CI 2.12-14.51 and OR 129; 95% CI 0.72-4.44).
  
  
  CONCLUSIONS
  Patients with prior HF admitted to hospital with PTE should be considered a high-risk population, since they present high in-hospital mortality. In our cohort, patients with prior HF and reduced LVEF presented a poorer prognosis than those with preserved LVEF.
authors: Servicio de Medicina Interna, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España. Electronic address: patrimed@gmail.com.
authors: Patricia
authors: P
authors: Lozano-Cruz
authors: Servicio de Cardiología, Hospital Universitario Clínico San Carlos, Madrid, España.
authors: David
authors: D
authors: Vivas
authors: Servicio de Medicina Interna, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España.
authors: Alexis
authors: A
authors: Rojas
authors: Servicio de Medicina Interna, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España.
authors: Rebeca
authors: R
authors: Font
authors: Servicio de Medicina Interna, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España.
authors: Feliciano
authors: F
authors: Román-García
authors: Servicio de Medicina Interna, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España.
authors: Benjamín
authors: B
authors: Muñoz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000150:complications* / Q000503:physiopathology; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D011655:Pulmonary Embolism / Q000150:complications / Q000175:diagnosis / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology
keywords: Cardiac failure; Fracción de eyección del ventrículo izquierdo; Insuficiencia cardiaca; Left ventricular eyection fraction; Prognosis; Pronóstico; Pulmonary thromboembolism; Tromboembolismo pulmonar