Outcomes and predictors of one-year mortality in patients hospitalized with Acute Heart Failure

Lorlowhakarn, Koravich; Arayakarnkul, Suchapa; Trongtorsak, Angkawipa; Leesutipornchai, Thiratest; Kewcharoen, Jakrin; Sinphurmsukskul, Supanee; Siwamogsatham, Sarawut; Puwanant, Sarinya; Ariyachaipanich, Aekarach

doi:10.1016/j.ijcha.2022.101159

Cited by 5 publications

(7 citation statements)

References 30 publications

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“…Additionally, our research emphasized that the risk of mortality was highest after HF hospitalization, with cardiovascular events being the leading cause of death in HF. These results are consistent with studies conducted not just in Thailand [ 8 , 12 , 21 ] and other Asian countries [ 22 , 23 ] but also in Western nations [ 18 , 24 , 25 ]. As a result, it emphasizes the significance of providing adequate treatment and preventative measures for cardiovascular events in patients with heart failure, particularly after hospitalization, to decrease morbidity and death.…”

Section: Discussionsupporting

confidence: 92%

“…In terms of in-hospital mortality, our research found that 11.0% of patients died during their hospital admission. This percentage was much higher than previous research at a medical school hospital in Thailand, which showed an in-hospital mortality rate of 5.8% [12]. Furthermore, our study's in-hospital mortality rate exceeded the Thai ADHERE study [7].…”

Section: Discussioncontrasting

confidence: 79%

“…Moreover, this rise in hospitalizations suggests a need for improved quality of care for patients with HF, particularly in the outpatient department. Supporting this hypothesis, a retrospective cohort study conducted in a tertiary care hospital in Thailand revealed that less than half of patients with HF received HF medications recommended by the national guideline, such as angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB), beta-blockers, and MRA at the time of hospital admission [ 12 ]. Conducting a comprehensive study that evaluates the appropriateness of care and treatment received in patients with HF is crucial.…”

Section: Introductionmentioning

confidence: 99%

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Real-World Clinical Burden of Newly Diagnosed Heart failure in Thai Patients

Boonyapiphat,

Tangkittikasem,

Torpongpun

et al. 2024

Cardiol Ther

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Introduction There are limited data on the burden of newly diagnosed patients with heart failure (HF) in Thailand. Thus, this study aimed to fully understand the hospitalization, rehospitalization, mortality rates, demographics and characteristics, and quality of care in these patients. Method A retrospective review of all eligible adult patients' medical records from 2018 and 2019 was conducted at five hospitals. The patients were newly diagnosed with HF, as indicated by the International Classification of Diseases (ICD)-10 code “I50.” Descriptive statistics was used to investigate patients' hospital burden and clinical outcome data. Results There were 1134 patients newly diagnosed with HF, classified as HF with reduced ejection fraction (HFrEF), HF with preserved ejection fraction (HFpEF), and HF with mildly reduced ejection fraction (HFmrEF) (44.0, 40.0, and 16.0%, respectively). The male-to-female ratios in HFmrEF and HFpEF were similar. In contrast, the proportion of men with HFrEF was greater. The mean age of all patients was 66.0 years. The hospitalization rate was 1.3. Rehospitalization rates for HF-related issues were 0.1, 0.2, 0.4, and 0.5 at 30 days, 60 days, 180 days, and 1 year, respectively. The percentage of deaths from all causes among these patients was 9.8%, while the percentage of deaths from cardiovascular-related causes was 8.5%. Only a small proportion of patients received a target dose of guideline-directed medical therapy (GDMT). Conclusions The study revealed that the characteristics, hospitalization rate for HF, and in-hospital mortality rate among newly diagnosed patients with HF were higher compared to similar studies conducted in Thailand and other countries. Moreover, a high quality of care is needed to improve the morbidity and mortality associated with HF in Thailand. Supplementary Information The online version contains supplementary material available at 10.1007/s40119-024-00366-5.

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Section: Discussionsupporting

confidence: 92%

Section: Discussioncontrasting

confidence: 79%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Real-World Clinical Burden of Newly Diagnosed Heart failure in Thai Patients

Boonyapiphat,

Tangkittikasem,

Torpongpun

et al. 2024

Cardiol Ther

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“…According to the subanalysis of the ESC Heart Failure Long‐Term Registry, 52 older age, NYHA class, CKD, lower blood pressure, and higher heart rate were independently associated with higher 1‐year mortality in chronic HFrEF patients. As for acute HF patients, in the recent publication of Lorlowhakarn et al, age, cardiovascular accidents, and NT‐proBNP level were associated with higher 1‐year mortality after acute HF hospitalization 53 . In the REPORT‐HF registry, patients hospitalized for acute decompensated HF and patients with worsening renal function had the highest mortality rates 54 .…”

Section: Discussionmentioning

confidence: 99%

“…As for acute HF patients, in the recent publication of Lorlowhakarn et al, age, cardiovascular accidents, and NT‐proBNP level were associated with higher 1‐year mortality after acute HF hospitalization. 53 In the REPORT‐HF registry, patients hospitalized for acute decompensated HF and patients with worsening renal function had the highest mortality rates. 54 In accordance with our findings, in the international cohort study by Lam et al, renal function was not revealed as an independent predictor of mortality.…”

Section: Discussionmentioning

confidence: 99%

The effect of kidney function on guideline‐directed medical therapy implementation and prognosis in heart failure with reduced ejection fraction

Bánfi‐Bacsárdi,

Pilecky,

Vámos

et al. 2024

Clinical Cardiology

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BackgroundKidney dysfunction (KD) is a main limiting factor of applying guideline‐directed medical therapy (GDMT) and reaching the recommended target doses (TD) in heart failure (HF) with reduced ejection fraction (HFrEF).HypothesisWe aimed to assess the success of optimization, long‐term applicability, and adherence of neurohormonal antagonist triple therapy (TT:RASi [ACEi/ARB/ARNI] + βB + MRA) according to the KD after a HF hospitalization and to investigate its impact on prognosis.MethodsThe data of 247 real‐world, consecutive patients were analyzed who were hospitalized in 2019−2021 for HFrEF and then were followed‐up for 1 year. The application and the ratio of reached TD of TT at hospital discharge and at 1 year were assessed comparing KD categories (eGFR: ≥90, 60−89, 45−59, 30−44, <30 mL/min/1.73 m2). Moreover, 1‐year all‐cause mortality and rehospitalization rates in KD subgroups were investigated.ResultsMajority of the patients received TT at hospital discharge (77%) and at 1 year (73%). More severe KD led to a lower application ratio (p < .05) of TT (92%, 88%, 80%, 73%, 31%) at discharge and at 1 year (81%, 76%, 76%, 68%, 40%). Patients with more severe KD were less likely (p < .05) to receive TD of MRA (81%, 68%, 78%, 61%, 52%) at discharge and a RASi (53%, 49%, 45%, 21%, 27%) at 1 year.One‐year all‐cause mortality (14%, 15%, 16%, 33%, 48%, p < .001), the ratio of all‐cause rehospitalizations (30%, 35%, 40%, 43%, 52%, p = .028), and rehospitalizations for HF (8%, 13%, 18%, 20%, 38%, p = .001) were significantly higher in more severe KD categories.ConclusionsKD unfavorably affects the application of TT in HFrEF, however poorer mortality and rehospitalization rates among them highlight the role of the conscious implementation and up‐titration of GDMT.

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