Dataset Information

Prognostic value of discharge heart rate in acute heart failure patients: More relevant in atrial fibrillation?

ABSTRACT: Aims:The prognostic impact of heart rate (HR) in acute heart failure (AHF) patients is not well known especially in atrial fibrillation (AF) patients. The aim of the study was to evaluate the impact of admission HR, discharge HR, HR difference (admission-discharge) in AHF patients with sinus rhythm (SR) or AF on long- term outcomes. Methods:We included 1398 patients consecutively admitted with AHF between October 2013 and December 2014 from a national multicentre, prospective registry. Logistic regression models were used to estimate the association between admission HR, discharge HR and HR difference and one- year all-cause mortality and HF readmission. Results:The mean age of the study population was 72?±?12?years. Of these, 594 (42.4%) were female, 655 (77.8%) were hypertensive and 655 (46.8%) had diabetes. Among all included patients, 745 (53.2%) had sinus rhythm and 653 (46.7%) had atrial fibrillation. Only discharge HR was associated with one year all-cause mortality (Relative risk (RR)?=?1.182, confidence interval (CI) 95% 1.024-1.366, p?=?0.022) in SR. In AF patients discharge HR was associated with one year all cause mortality (RR?=?1.276, CI 95% 1.115-1.459, p???0.001). We did not observe a prognostic effect of admission HR or HRD on long-term outcomes in both groups. This relationship is not dependent on left ventricular ejection fraction. Conclusions:In AHF patients lower discharge HR, neither the admission nor the difference, is associated with better long-term outcomes especially in AF patients.

SUBMITTER: Rosa AB

PROVIDER: S-EPMC7046516 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Prognostic value of discharge heart rate in acute heart failure patients: More relevant in atrial fibrillation?

Rosa Agra Bermejo AB Domingo Pascual-Figal PF Francisco Gude Sampedro GS Juan Delgado Jiménez DJ Rafael Vidal Pérez VP Inés Gómez Otero GO Andreu Ferrero-Gregori FG Jesús Álvarez-García ÁG Fernando Worner Diz WD Jesús Segovia S María Generosa Crespo-Leiro CL Juan Cinca Cuscullol CC Francisco Fernández Avilés FA Jose Ramón Gónzalez-Juanatey GJ

International journal of cardiology. Heart & vasculature 20191204

<h4>Aims</h4>The prognostic impact of heart rate (HR) in acute heart failure (AHF) patients is not well known especially in atrial fibrillation (AF) patients. The aim of the study was to evaluate the impact of admission HR, discharge HR, HR difference (admission-discharge) in AHF patients with sinus rhythm (SR) or AF on long- term outcomes.<h4>Methods</h4>We included 1398 patients consecutively admitted with AHF between October 2013 and December 2014 from a national multicentre, prospective regi ...[more]

PMID: 32140546

Similar Datasets

Project description:Background Maximal left atrial (LA) volume is reported by most echocardiography laboratories and is associated with clinical outcomes in patients with heart failure (HF). Recent studies suggest that minimal LA volume may better reflect left ventricular filling pressure and may be more prognostic than maximal LA volume. This study assessed the prognostic value of indexed minimal LA volume (LAVImin) in patients with HF with preserved ejection fraction. Methods and Results We assessed the relationship of LAVImin with a primary composite end point of cardiovascular death, aborted cardiac death, or HF hospitalization in 347 patients with HF with preserved ejection fraction enrolled from the Americas region in TOPCAT (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist Trial). We compared LAVImin with indexed maximal LA volume with respect to their prognostic values. In addition, we assessed if LA functional parameters provide additional prognostic information over LAVImin. During a median follow-up of 2.5 years, 107 patients (31%) experienced a primary composite end point. LAVImin was associated with increased risk of a primary composite outcome (hazard ratio [HR], 1.35; 95% CI, 1.12-1.61) and HF hospitalization alone (HR, 1.42; 95% CI, 1.17-1.71) after adjusting for clinical confounders and ejection fraction. In contrast, indexed maximal LA volume was not related to the primary composite outcome, but related to HF alone (HR, 1.25; 95% CI, 1.02-1.54). In comparison with indexed maximal LA volume, LAVImin was significantly more prognostic for primary composite outcome (P for comparison=0.032). Both LA emptying fraction and LA strain were prognostic of primary outcome independent of LAVImin (all P<0.05). Conclusions In patients with HF with preserved ejection fraction, LAVImin was more predictive of cardiovascular outcome than indexed maximal LA volume, suggesting this measure may be more physiologically relevant and might better identify patients at high risk for cardiovascular events. LA functional parameters provide prognostic information independent of LAVImin. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT00094302.

Dataset Information

Prognostic value of discharge heart rate in acute heart failure patients: More relevant in atrial fibrillation?

Publications

Prognostic value of discharge heart rate in acute heart failure patients: More relevant in atrial fibrillation?

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets