PT  - JOURNAL ARTICLE
AU  - Choi, Ki Hong
AU  - Lee, Ga Yeon
AU  - Choi, Jin-Oh
AU  - Jeon, Eun-Seok
AU  - Lee, Hae-Young
AU  - Cho, Hyun-Jai
AU  - Lee, Sang Eun
AU  - Kim, Min-Seok
AU  - Kim, Jae-Joong
AU  - Hwang, Kyung-Kuk
AU  - Chae, Shung Chull
AU  - Baek, Sang Hong
AU  - Kang, Seok-Min
AU  - Choi, Dong-Ju
AU  - Yoo, Byung-Su
AU  - Kim, Kye Hun
AU  - Park, Hyun-Young
AU  - Cho, Myeong-Chan
AU  - Oh, Byung-Hee
TI  - Outcomes of de novo and acute decompensated heart failure patients according to ejection fraction
AID  - 10.1136/heartjnl-2017-311813
DP  - 2018 Mar 01
TA  - Heart
PG  - 525--532
VI  - 104
IP  - 6
4099  - http://heart.bmj.com/content/104/6/525.short
4100  - http://heart.bmj.com/content/104/6/525.full
SO  - Heart2018 Mar 01; 104
AB  - Objective There are conflicting results among previous studies regarding the prognosis of heart failure with preserved ejection fraction (HFpEF) compared with heart failure with reduced ejection fraction (HFrEF). This study aimed to compare the outcomes of patients with de novo acute heart failure (AHF) or acute decompensated HF (ADHF) according to HFpEF (EF≥50%), or HFrEF (EF<40%) and to define the prognosis of patients with HF with mid-range EF (HFmrEF, 40≤EF<50%).Methods Between March 2011 and February 2014, 5625 consecutive patients with AHF were recruited from 10 university hospitals. A total of 5414 (96.2%) patients with EF data were enrolled, which consisted of 2867 (53.0%) patients with de novo and 2547 (47.0%) with ADHF. Each of the enrolled group was stratified by EF.Results In de novo, all-cause death rates were not significantly different between HFpEF and HFrEF (HFpEF vs HFrEF, 206/744 (27.7%) vs 438/1631 (26.9%), HRadj 1.15, 95% CI 0.96 to 1.38, p=0.14). However, among patients with ADHF, HFrEF had a significantly higher mortality rate compared with HFpEF (HFpEF vs HFrEF, 245/613 (40.0%) vs 694/1551 (44.7%), HRadj 1.25, 95% CI 1.06 to 1.47, p=0.007). Also, in ADHF, HFmrEF was associated with a significantly lower mortality rate within 1 year compared with HFrEF (HFmrEF vs HFrEF, 88/383 (23.0%) vs 430/1551 (27.7%), HRadj 1.31, 95% CI 1.03 to 1.65, p=0.03), but a significantly higher mortality rate after 1 year compared with HFpEF (HFmrEF vs HFpEF, 83/295 (28.1%) vs 101/469 (21.5%), HRadj 0.70, 95% CI 0.52 to 0.96, p=0.02).Conclusions HFpEF may indicate a better prognosis compared with HFrEF in ADHF, but not in de novo AHF. For patients with ADHF, the prognosis associated with HFmrEF was similar to that of HFpEF within the first year following hospitalisation and similar to HFrEF 1  year after hospitalisation.