Long-term survival after hospitalization for acute heart failure — Differences in prognosis of acutely decompensated chronic and new-onset acute heart failure

Lassus, Johan; Siirilä-Waris, Krista; Nieminen, Markku S.; Tolonen, Jukka; Tarvasmäki, Tuukka; Peuhkurinen, Keijo; Melin, John; Pulkki, Kari; Harjola, Veli‐Pekka

doi:10.1016/j.ijcard.2012.09.128

Cited by 81 publications

(78 citation statements)

References 26 publications

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“…Only a few prospective AHF registries have reported long-term mortality rates beyond 1 year after hospital discharge. 16,17 The FINN-AKVA study group investigated 620 patients with AHF from Finland and reported 5-year mortality rates of 75.6% in ACHF versus 44.4% in de novo AHF. 16 Similar to our findings, they also found that the increase in mortality peaked during the first year posthospital discharge.…”

Section: Discussionmentioning

confidence: 99%

“…However, the majority of AHF studies have been performed in North America and Europe. [7][8][9][10][11][12][13][14][15][16][17][18] Only scarce data are available regarding HF in Arab populations, which have different ethnic and cultural backgrounds. [19][20][21][22][23] Furthermore, only a few recent comparative studies have reported long-term mortality rates beyond 1 year from hospital discharge for patients with de novo AHF and ACHF.…”

Section: Introductionmentioning

confidence: 99%

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Long-Term Mortality Rates in Acute De Novo Versus Acute-on-Chronic Heart Failure

et al. 2014

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Long-Term Mortality Rates in Acute De Novo Versus Acute-on-Chronic Heart Failure

et al. 2014

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“…AHF remains the most relevant clinical event in HF progression and is associated with high rates of mortality21, 44 and hospital readmission,21, 23 frequently occurring early after discharge 23. Nevertheless, there is a remarkable lack of evidence regarding the optimal management of patients after haemodynamic stabilization following hospitalization for AHF.…”

Section: Rationale For the Transition Studymentioning

confidence: 99%

Rationale and design of TRANSITION: a randomized trial of pre‐discharge vs. post‐discharge initiation of sacubitril/valsartan

et al. 2017

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AimsThe prognosis after hospitalization for acute decompensated heart failure (ADHF) remains poor, especially <30 days post‐discharge. Evidence‐based medications with prognostic impact administered at discharge improve survival and hospital readmission, but robust studies comparing pre‐discharge with post‐discharge initiation are rare. The PARADIGM‐HF trial established sacubitril/valsartan as a new evidence‐based therapy in patients with heart failure (HF) and reduced left ventricular ejection fraction (<40%) (rEF). In common with other landmark studies, it enrolled patients who were ambulatory at the time of inclusion. In addition, there is also still limited knowledge of initiation and up‐titration of sacubitril/valsartan in ACEi/ARB‐ naïve patients and in de novo HF with rEF patients.Methods and results TRANSITION is a multicentre, open‐label study in which ~1000 adults hospitalized for ADHF with rEF are randomized to start sacubitril/valsartan in a pre‐discharge arm (initiated ≥24 h after haemodynamic stabilization) or a post‐discharge arm (initiated within Days 1–14 after discharge). The protocol allows investigators to select the appropriate starting dose and dose adjustments according to clinical circumstances. Over a 10 week treatment period, the primary and secondary objectives assess the feasibility and safety of starting sacubitril/valsartan in‐hospital, early after haemodynamic stabilization. Exploratory objectives also include assessment of HF signs and symptoms, readmissions, N‐terminal pro‐B‐type natriuretic peptide and high‐sensitivity troponin T levels, and health resource utilization parameters.Conclusions TRANSITION will provide new evidence about initiating sacubitril/valsartan following hospitalization for ADHF, occurring either as de novo ADHF or as deterioration of chronic HF, and in patients with or without prior ACEI/ARB therapy. The results of TRANSITION will thus be highly relevant to the management of patients hospitalized for ADHF with rEF.

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“…Several recent studies have reported on the 1‐year prognosis of patients with acute heart failure4, 11, 12, 13, 14, 15, 16 and 3 have analyzed longer follow‐up,15, 16, 17 one of them with decompensated heart failure and pulmonary edema 17. In contrast, long‐term follow‐up in patients with well‐defined APE has been limited to 1 year and has been described in only 2 old reports with a reduced number of patients 7, 18.…”

Section: Introductionmentioning

confidence: 99%

Hospital and 4‐Year Mortality Predictors in Patients With Acute Pulmonary Edema With and Without Coronary Artery Disease

Figueras

Bañeras

Peña‐Gil

et al. 2016

JAHA

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BackgroundLong‐term prognosis of acute pulmonary edema (APE) remains ill defined.Methods and ResultsWe evaluated demographic, echocardiographic, and angiographic data of 806 consecutive patients with APE with (CAD) and without coronary artery disease (non‐CAD) admitted from 2000 to 2010. Differences between hospital and long‐term mortality and its predictors were also assessed. CAD patients (n=638) were older and had higher incidence of diabetes and peripheral vascular disease than non‐CAD (n=168), and lower ejection fraction. Hospital mortality was similar in both groups (26.5% vs 31.5%; P=0.169) but APE recurrence was higher in CAD patients (17.3% vs 6.5%; P<0.001). Age, admission systolic blood pressure, recurrence of APE, and need for inotropics or endotracheal intubation were the main independent predictors of hospital mortality. In contrast, overall mortality (70.0% vs 57.1%; P=0.002) and readmission for nonfatal heart failure after a 45‐month follow‐up (10–140; 17.3% vs 7.6%; P=0.009) were higher in CAD than in non‐CAD patients. Age, peripheral vascular disease, and peak creatine kinase MB during index hospitalization, but not ejection fraction, were the main independent predictors of overall mortality, whereas coronary revascularization or valvular surgery were protective. These interventions were mostly performed during hospitalization index (294 of 307; 96%) and not intervened patients showed a higher risk profile.ConclusionsLong‐term mortality in APE is high and higher in CAD than in non‐CAD patients. Considering the different in‐hospital and long‐term mortality predictors herein described, which do not necessarily involve systolic function, it is conceivable that a more aggressive interventional program might improve survival in high‐risk patients.

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Long-term survival after hospitalization for acute heart failure — Differences in prognosis of acutely decompensated chronic and new-onset acute heart failure

Cited by 81 publications

References 26 publications

Long-Term Mortality Rates in Acute De Novo Versus Acute-on-Chronic Heart Failure

Long-Term Mortality Rates in Acute De Novo Versus Acute-on-Chronic Heart Failure

Rationale and design of TRANSITION: a randomized trial of pre‐discharge vs. post‐discharge initiation of sacubitril/valsartan

Hospital and 4‐Year Mortality Predictors in Patients With Acute Pulmonary Edema With and Without Coronary Artery Disease

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