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Impact of identifying precipitating factors on 30-day mortality in acute heart failure patients

Fecha de publicación: Fecha Ahead of Print:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Rossello, X
  • Gil, V
  • Escoda, R
  • Jacob, J
  • Aguirre, A
  • Martin-Sanchez, FJ
  • Llorens, P
  • Puente, PH
  • Rizzi, M
  • Raposeiras-Roubin, S
  • Wussler, D
  • Muller, CE
  • Gayat, E
  • Mebazaa, A
  • Miro, O
  • Fuentes, M
  • Gil, C
  • Alonso, H
  • Perez-Llantada, E
  • Martin-Sanchez, FJ
  • Garcia, GL
  • Cadenas, MS
  • Xipell, C
  • Sanchez, C
  • Pavon, J
  • Noval, A
  • Tones, JM
  • Lopez-Grima, ML
  • Valero, A
  • Juan, MA
  • Pedragosa, MA
  • Maso, SM
  • Alonso, MI
  • Ruiz, F
  • Franco, JM
  • Mecina, AB
  • Tost, J
  • Berenguer, M
  • Donea, R
  • Ramon, SS
  • Rodriguez, VC
  • Pinera, P
  • Nicolas, JAS
  • Garate, RT
  • Alquezar-Arbe, A
  • Rizzi, MA
  • Herrera, S
  • Roset, A
  • Cabello, I
  • Haro, A
  • Richard, F
  • Perez, JMA
  • Diez, MPL
  • Alvarez, JV
  • Garcia, BP
  • Garcia, MG
  • Gonzalez, MS
  • Javaloyes, P
  • Marquina, V
  • Jimenez, I
  • Hernandez, N
  • Brouzet, B
  • Espinosa, B
  • Andueza, JA
  • Romero, R
  • Ruiz, M
  • Calvache, R
  • Serralta, MTL
  • Jave, LEC
  • Arriaga, BA
  • Bergua, BS
  • Mojarro, EM
  • Jimenez, BSA
  • Becquer, LT
  • Burillo, G
  • Garcia, LL
  • LaSalle, GC
  • Urbano, CA
  • Soto, ABG
  • Padial, ED
  • Ferrer, ES
  • Garrido, JM
  • Lucas-Imbernon, FJ
  • Gaya, R
  • Bibiano, C
  • Mir, M
  • Rodriguez, B
  • Carballo, JL
  • Rodriguez-Adrada, E
  • Miranda, BR
  • ICA-SEMES Res Grp

Grupos

Abstract

Background: The aim of this study was to describe the prevalence and prognostic value of the most common triggering factors in acute heart failure. Methods: Patients with acute heart failure from 41 Spanish emergency departments were recruited consecutively in three time periods between 2011 and 2016. Precipitating factors were classified as: (a) unrecognized; (b) infection; (c) atrial fibrillation; (d) anaemia; (e) hypertension; (f) acute coronary syndrome; (g) non-adherence; and (h) two or more precipitant factors. Unadjusted and adjusted logistic regression models were used to assess the association between 30-day mortality and each precipitant factor. The risk of dying was further evaluated by week intervals over the 30-day follow-up to assess the period of higher vulnerability for each precipitant factor. Results: Approximately 69% of our 9999 patients presented with a triggering factor and 1002 died within the first 30 days (10.0%). The most prevalent factors were infection and atrial fibrillation. After adjusting for 11 known predictors, acute coronary syndrome was associated with higher 30-day mortality (odds ratio (OR) 1.87; 95% confidence interval (CI) 1.02-3.42), whereas atrial fibrillation (OR 0.75; 95% CI 0.56-0.94) and hypertension (OR 0.34; 95% CI 0.21-0.55) were significantly associated with better outcomes when compared to patients without precipitant. Patients with infection, anaemia and non-compliance were not at higher risk of dying within 30 days. These findings were consistent across gender and age groups. The 30-day mortality time pattern varied between and within precipitant factors. Conclusions: Precipitant factors in acute heart failure patients are prevalent and have a prognostic value regardless of the patient's gender and age. They can be managed with specific treatments and can sometimes be prevented.

Datos de la publicación

ISSN/ISSNe:
2048-8726, 2048-8734

EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE  SAGE Publications Ltd

Tipo:
Article
Páginas:
667-680
PubMed:
31436133
Factor de Impacto:
1,630 SCImago ℠
Cuartil:
Q1 SCImago ℠

Citas Recibidas en Web of Science: 12

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Keywords

  • Acute heart failure; precipitant factors; mortality; outcome

Campos de Estudio

Proyectos y Estudios Clínicos

PRAGMATIC, CONTROLLED, INTERNATIONAL STUDY CONDUCTED IN SEVERAL CENTRES ON THE SAFETY AND THERAPEUTIC EFFECT OF A HYDROXYLETHYL-STARCH (HES) SOLUTION VERSUS AN ELECTROLYTE SOLUTION IN TRAUMA PATIENTS.

Investigador Principal: ÓSCAR DÍAZ CAMBRONERO

HC-G-H-1505 . 2018

EFECTO DE V0251 EN EL VÉRTIGO AGUDO. ESTUDIO ALEATORIZADO, DOBLE CIEGO Y CONTROLADO CON PLACEBO.

Investigador Principal: HERMINIO PÉREZ GARRIGUES

V00251IV2024A

PERFIL DE RIESGO DE LOS PACIENTES CON ETV EN HOSPITALES ESPAÑOLES ATENDIDOS EN LOS SERVICIOS DE URGENCIAS E IMPACTO ASISTENCIAL: REGISTRO ESPHERIA.

Investigador Principal: MARÍA JOSÉ PÉREZ DURÁ

ESPHERIA

PLANIFICACIÓN DEL ALTA DESDE URGENCIAS PARA REDUCIR REINGRESOS A 30 DÍAS EN MAYORES FRÁGILES CON INSUFICIENCIA CARDÍACA AGUDA: ENSAYO CLÍNICO ALEATORIZADO POR CONGLOMERADOS PAREADO.

Investigador Principal: CARMEN GARGALLO MAICAS

DEED FRAIL-AHF . 2019

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