RT Journal Article
SR Electronic
T1 Outcomes of de novo and acute decompensated heart failure patients according to ejection fraction
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 525
OP 532
DO 10.1136/heartjnl-2017-311813
VO 104
IS 6
A1 Choi, Ki Hong
A1 Lee, Ga Yeon
A1 Choi, Jin-Oh
A1 Jeon, Eun-Seok
A1 Lee, Hae-Young
A1 Cho, Hyun-Jai
A1 Lee, Sang Eun
A1 Kim, Min-Seok
A1 Kim, Jae-Joong
A1 Hwang, Kyung-Kuk
A1 Chae, Shung Chull
A1 Baek, Sang Hong
A1 Kang, Seok-Min
A1 Choi, Dong-Ju
A1 Yoo, Byung-Su
A1 Kim, Kye Hun
A1 Park, Hyun-Young
A1 Cho, Myeong-Chan
A1 Oh, Byung-Hee
YR 2018
UL http://heart.bmj.com/content/104/6/525.abstract
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.