| Resum: |
Introduction: Acute heart failure (AHF) represents a critical event in heart failure progression, but data on long-term outcomes after first hospitalization remain scarce. The aim is to describe long-term survival and evaluate its predictors after the first episode of AHF. Material and methods: Patients from five Spanish hospitals with a confirmed first diagnosis of AHF were categorized based on survival (≥5 or <5 years). Thirteen independent variables were identified. Mortality was assessed using Kaplan-Meier curves after up to 10 years of follow-up. Adjusted odds ratios (OR) with 95% confidence intervals (CI) for mortality were calculated. Additionally, adjusted survival probabilities according to patient age and left ventricular ejection fraction (LVEF) were obtained using restricted cubic splines. Results: A total of 1986 patients were included, with a median age 76 years (range: 68-82), 50% women, and 57% with preserved LVEF. Five-year mortality was 52%. Adjusted analysis showed that age (OR, 0. 470 per 10-year increment; 95% CI, 0. 421-0. 525), New York Heart Association class III-IV vs. I (OR, 0. 476; 95% CI, 0. 341-0. 666) and II vs. I (OR, 0. 780; 95% CI, 0. 627-0. 969), chronic kidney disease (OR, 0. 609; 95% CI, 0. 452-0. 820), coronary artery disease (OR, 0. 657; 95% CI, 0. 523-0. 824), diabetes mellitus (OR, 0. 658; 95% CI, 0. 534-0. 811), and male sex (OR, 0. 774; 95% CI, 0. 625-0. 958) were associated with death within 5 years. LVEF at inclusion was not related to 5-year survival. Conclusions: Survival after a first AHF episode is poor, with age, NewYork Heart Association class, kidney function, coronary artery disease, diabetes, and sex being key predictors of long-term mortality. |
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identificació
(Universitat Autònoma de Barcelona)
