Survival of heart failure patients with reduced and preserved ejection fraction is not different!

    Authors

    Keywords

    heart failure, mortality

    DOI

    https://doi.org/10.15836/ccar2019.221

    Full Text

    Introduction : A progress in the management of cardiovascular disease leads to a decrease in mortality, but heart failure (HF) seems to be an exception. Today, the rate of rehospitalization and mortality after acute heart failure is still very high. Lower ejection fraction (EF) means worse prognosis, but recent studies are reporting that HF patients with preserved EF have no better survival compared to patients with reduced EF ( 1 ). Goal: to investigate a possible difference in the outcome of HF patients with reduced (HFREF) and preserved ejection fraction (HFPEF). Patients and Methods : In 222 patients hospitalized in acute HF (138 with reduced EF and 74 with preserved EF) were determined routine laboratory test, including BNP. The LVEF cutoff for diagnosing of HFPEF was above 45%. Patients were followed for the next 18 months for the occurrence of 1. readmission due to repeat decompensation and 2. mortality. Results : BNP at discharge was higher in HFREF compared to HFPEF group [699.3 (271.8-1519.1) pg/ml vs 263.3 (134.4-502.2) pg/ml, p <0.001]. During 18-month follow-up 129 patients (58.11%) were readmitted due to decompensation, but there was no significant difference between group: in HFREF group was hospitalized 87 (63.04%) patients compared to 42 (50%) patients in HFPEF group (p=0.077). There was no difference in the rate of readmission in 1-month (p=0.7), 6-month (p=0.24), and 12-month follow up (p=0.16) in HFREF vs HFPEF group. In Kaplan-Meier curve there was no significant difference in the mean time of the occurrence of readmission due to decompensation: in HFREF group 2.2 (95% CI=1.58-2.8) months and in HFPEF group 2.33 (95% CI=1.3-3.4) months (p=0.89) ( Figure 1 ). In HFREF 18-month survival was 43.5% (60/138) and in HFPEF group was 56.0% (47/84) and the difference was not significant (p=0,096). In the Kaplan-Meier curve, there was no difference in time of survival in 18-month follow-up (p=0.9): mean time of survival in HFREF was 3.8 (95% CI=3.0-4.7) months and in HFPEF 3.75 (95% CI=2.5-5.0) months ( Figure 2 ). There was no difference in mortality in 1-month (p=0.8), 6-month (p=0.16) and 12-month follow up (p=0.08). Admission due to decompensated heart failure in the group of heart failure patients with reduced (HFREF) and preserved ejection fraction (HFPEF). Kaplan-Meier survival curve in in the group of heart failure patients with reduced (HFREF) and preserved ejection fraction (HFPEF) in an 18-month period. Conclusion : Rate of rehospitalization due to decompensation and mortality is not different between HFREF and HFPEF group. Preserved EF is not related to better survival in patients with HF.

    Cardiologia Croatica
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    Survival of heart failure patients with reduced and preserved ejection fraction is not different!

    Extended Abstract
    Issue9-10
    Published
    Pages221
    PDF via DOIhttps://doi.org/10.15836/ccar2019.221
    heart failure
    mortality

    Authors

    Azra Durak-Nalbantić*ORCID
    Alen DžuburORCID
    Nafija SerdarevićORCID
    Aida Hamzić-MehmedbašićORCID
    Faris ZvizdićORCID
    Enisa Hodžić
    Marina Vučijak-GrgurevićORCID
    Alden BegićORCID
    Akif MlaćoORCID
    Zenisa Gljiva-GogićORCID

    Full Text

    Introduction : A progress in the management of cardiovascular disease leads to a decrease in mortality, but heart failure (HF) seems to be an exception. Today, the rate of rehospitalization and mortality after acute heart failure is still very high. Lower ejection fraction (EF) means worse prognosis, but recent studies are reporting that HF patients with preserved EF have no better survival compared to patients with reduced EF ( 1 ). Goal: to investigate a possible difference in the outcome of HF patients with reduced (HFREF) and preserved ejection fraction (HFPEF). Patients and Methods : In 222 patients hospitalized in acute HF (138 with reduced EF and 74 with preserved EF) were determined routine laboratory test, including BNP. The LVEF cutoff for diagnosing of HFPEF was above 45%. Patients were followed for the next 18 months for the occurrence of 1. readmission due to repeat decompensation and 2. mortality. Results : BNP at discharge was higher in HFREF compared to HFPEF group [699.3 (271.8-1519.1) pg/ml vs 263.3 (134.4-502.2) pg/ml, p <0.001]. During 18-month follow-up 129 patients (58.11%) were readmitted due to decompensation, but there was no significant difference between group: in HFREF group was hospitalized 87 (63.04%) patients compared to 42 (50%) patients in HFPEF group (p=0.077). There was no difference in the rate of readmission in 1-month (p=0.7), 6-month (p=0.24), and 12-month follow up (p=0.16) in HFREF vs HFPEF group. In Kaplan-Meier curve there was no significant difference in the mean time of the occurrence of readmission due to decompensation: in HFREF group 2.2 (95% CI=1.58-2.8) months and in HFPEF group 2.33 (95% CI=1.3-3.4) months (p=0.89) ( Figure 1 ). In HFREF 18-month survival was 43.5% (60/138) and in HFPEF group was 56.0% (47/84) and the difference was not significant (p=0,096). In the Kaplan-Meier curve, there was no difference in time of survival in 18-month follow-up (p=0.9): mean time of survival in HFREF was 3.8 (95% CI=3.0-4.7) months and in HFPEF 3.75 (95% CI=2.5-5.0) months ( Figure 2 ). There was no difference in mortality in 1-month (p=0.8), 6-month (p=0.16) and 12-month follow up (p=0.08). Admission due to decompensated heart failure in the group of heart failure patients with reduced (HFREF) and preserved ejection fraction (HFPEF). Kaplan-Meier survival curve in in the group of heart failure patients with reduced (HFREF) and preserved ejection fraction (HFPEF) in an 18-month period. Conclusion : Rate of rehospitalization due to decompensation and mortality is not different between HFREF and HFPEF group. Preserved EF is not related to better survival in patients with HF.