© 2005 European Society of Cardiology
Acute heart failure: Clinical presentation, one-year mortality and prognostic factors
a Department of Medicine, University Hospital Zürich Switzerland
b Department of Medicine, Helsinki University Central Hospital Finland
* Corresponding author. Present address: Wolfson Institute of Biomedical Research, University College London, The Cruciform Building, Gower Street, London WC 1E 6BT. Tel.: +44 207 679 6666; Fax: +44 207 691 3104. E-mail address: arudiger99{at}yahoo.de
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Abstract |
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Aims: Acute heart failure (HF) is a common but ill-defined clinical entity. We describe patients hospitalised with acute HF in regard of clinical presentation, mortality, and risk factors for an unfavourable outcome.
Methods and results: We conducted a prospective study including 312 consecutive patients from two European centers hospitalised with acute HF, defined as new onset or worsening of symptoms and signs of HF within 7 days. The mean age was 73 years and 56% were men. Twenty-eight percent had de-novo acute HF and 72% a decompensation of chronic HF. Coronary heart disease (CHD) was the most frequent underlying heart disease, elevated blood pressure >150 mmHg and acute ischemia being the most important triggers. Four percent of the patients had cardiogenic shock, 13% presented with pulmonary edema. LV-EF was <35%, 35–50% and >50% in 35%, 32% and 33% of the patients, respectively. ICU-treatment was necessary in 39% of the patients. Thirty-day mortality (11%) was increased in the presence of shock or elevated troponin T levels. Twelve-month all-cause mortality (29%) increased in the presence of shock, left ventricular dysfunction, renal insufficiency, CHD, and age.
Conclusions: This prospective study shows that despite modern treatment, morbidity and mortality of patients hospitalised with acute HF remain high.
Key Words: Acute heart failure • Cardiogenic shock • Pulmonary oedema • Mortality
Received August 9, 2004; Revised November 25, 2004; Accepted January 27, 2005
1 A. Rudiger and V.-P. Harjola contributed equally to this survey.
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