Short to long term mortality of patients hospitalised with heart failure in the Czech Republic—a report from the EuroHeart Failure Survey

Abstract

Background and aim: The European Society of Cardiology initiated the EuroHeart Failure Survey to obtain more data about the quality of care in patients hospitalised with suspected heart failure (HF). The Czech Republic was 1 of the 24 European Society countries included in the survey. The aim of this report is to extend the original follow-up period of 12 weeks out to 4 years to assess mortality. Methods: All admitted patients were screened according to the EuroHeart Survey Protocol, over a 6-week period in six hospitals in Pilsen, Prague and Brno in the year 2000. Annual mortality and cause of death were obtained from the Prague Institute for Health Statistical Information (UZIS Praha). Results: A total of 2365 patients were screened and about 25% of all admitted patients fulfilled the criteria for HF. About 14% of patients died between admission and the 12-week follow-up, 36% of male and 42% of female patients died during the 4-year follow-up (2000 -2003). Cardiovascular diseases were the main causes of death (92%). Deceased patients were significantly older, had lower haemoglobin and total plasma cholesterol level, and had renal insufficiency and higher levels of big endothelin and BNP than the survivors. Mortality risk was increased independently by positive history of previous myocardial infarction OR = 2.39 (1.59 -3.59), by age OR = 1.03 (1.01 -1.05) and by plasma creatinine level OR = 1.04 (1.01 -1.07). Treatment with diuretics and digoxin was associated with a higher risk of death; by contrast, a protective effect of beta-blockers and statins was found in these HF patients. Conclusion: Patients with HF were older and had a poor prognosis; approximately one third of the patients will die within 3 years.

<b>The Profile and Prognosis of Patients Hospitalised With Heart Failure</b>

“…A diagnosis of heart failure recorded in the hospital notes at any time during the previous 3 years. 3. Administration of a loop diuretic due to dyspnea.…”

“…Paradoxically, improvements in the treatment of hypertension and myocardial infarction, although delaying the onset of heart failure, may increase its incidence and prevalence further. 3,6) The mean age of patients hospitalised for acute coronary syndromes in our registry was 66 and the in-patient mortality rate was only 5.1% in the 2005. 6) A clear understanding of the health and social challenges set by heart failure is thus of considerable interest for the community and health services.…”

Effect of previous statin use on the incidence of sustained ventricular tachycardia and ventricular fibrillation in patients presenting with acute coronary syndrome

“…Their use has also been associated with lower rate of mortality (13,16,27,28), which could partly be explained by reduced rate of ventricular arrhythmias. On the other hand, statins have been found to be ineffective in preventing ventricular arrhythmias in patients with highrisk hypertension (4), resuscitated cardiac arrest in diabetic patients (29), or in patients with chronic CAD (3,(18)(19)(20).…”

Statins as Anti‐Arrhythmics: A Systematic Review Part II: Effects on Risk of Ventricular Arrhythmias

“…17 An association of statins with lower mortality rates was also noted in the EuroHeart Failure survey. 18 The Controlled Rosuvastatin Multinational Trial in Heart Failure (CORONA) 15 was recently published. In this study, a total of 5011 heart failure patients were randomly assigned to receive 10 mg of rosuvastatin or placebo per day.…”