Kui Toh Gerard Leong1, Cao Yan2, Ping Ping Goh1. 1. Department of Cardiology, Changi General Hospital, Singapore. 2. Case Management Unit, Changi General Hospital, Singapore.
Abstract
OBJECTIVES: To identify acute heart failure (HF) precipitants in patients with a history of chronic HF, and to analyse any relationship with early outcomes. BACKGROUND: There are limited studies on acute HF precipitants and the relationship with outcomes, and determining this will help to identify the avoidable precipitants and may lead to better outcomes. METHODS: Patients with a history of HF and admission to the authors' hospital in 2008, with a discharge primary diagnosis of HF, were enrolled. Diagnosis of HF was prospectively defined and reviewed by two cardiology teams. Patients' case records were reviewed, or families were interviewed for 1-month follow-up outcome information. RESULTS: 242 admissions by 185 patients constituted our study cohort. Patients were older, and 36.8% were females. The ethnic Chinese, Malay and Indian composition of the cohort were 41.3%, 35.1% and 16.1% respectively. The mean left-ventricular ejection fraction was 34.0±17.5%. Preserved left ventricular ejection fraction (≥45%) constituted 35.1% of the cohort. Acute HF precipitants were identified in 62.8% of admissions and unidentified in 37.2% admissions. Non-compliance issues and infections constituted 27.2% and 13.6% of precipitants respectively. Cardiac precipitants accounted for 10.0% admissions. Multiple precipitants accounted for 8.3% admissions. There were no significant differences in patient profile, including ethnicity and gender, and outcomes between patients with identified precipitants and patients with unidentified precipitants. CONCLUSION: Non-compliance issues were a major precipitant of acute HF in patients with chronic HF. Precipitants were not determined in 37.2% of admissions. There were no significant associations between the different types of precipitants and early 30-day outcomes.
OBJECTIVES: To identify acute heart failure (HF) precipitants in patients with a history of chronic HF, and to analyse any relationship with early outcomes. BACKGROUND: There are limited studies on acute HF precipitants and the relationship with outcomes, and determining this will help to identify the avoidable precipitants and may lead to better outcomes. METHODS:Patients with a history of HF and admission to the authors' hospital in 2008, with a discharge primary diagnosis of HF, were enrolled. Diagnosis of HF was prospectively defined and reviewed by two cardiology teams. Patients' case records were reviewed, or families were interviewed for 1-month follow-up outcome information. RESULTS: 242 admissions by 185 patients constituted our study cohort. Patients were older, and 36.8% were females. The ethnic Chinese, Malay and Indian composition of the cohort were 41.3%, 35.1% and 16.1% respectively. The mean left-ventricular ejection fraction was 34.0±17.5%. Preserved left ventricular ejection fraction (≥45%) constituted 35.1% of the cohort. Acute HF precipitants were identified in 62.8% of admissions and unidentified in 37.2% admissions. Non-compliance issues and infections constituted 27.2% and 13.6% of precipitants respectively. Cardiac precipitants accounted for 10.0% admissions. Multiple precipitants accounted for 8.3% admissions. There were no significant differences in patient profile, including ethnicity and gender, and outcomes between patients with identified precipitants and patients with unidentified precipitants. CONCLUSION: Non-compliance issues were a major precipitant of acute HF in patients with chronic HF. Precipitants were not determined in 37.2% of admissions. There were no significant associations between the different types of precipitants and early 30-day outcomes.
Authors: Kenneth Dickstein; Alain Cohen-Solal; Gerasimos Filippatos; John J V McMurray; Piotr Ponikowski; Philip Alexander Poole-Wilson; Anna Strömberg; Dirk J van Veldhuisen; Dan Atar; Arno W Hoes; Andre Keren; Alexandre Mebazaa; Markku Nieminen; Silvia Giuliana Priori; Karl Swedberg Journal: Eur J Heart Fail Date: 2008-09-16 Impact factor: 15.534
Authors: C Opasich; O Febo; P G Riccardi; E Traversi; G Forni; G Pinna; M Pozzoli; R Riccardi; A Mortara; M Sanarico; F Cobelli; L Tavazzi Journal: Am J Cardiol Date: 1996-08-01 Impact factor: 2.778
Authors: J G F Cleland; K Swedberg; F Follath; M Komajda; A Cohen-Solal; J C Aguilar; R Dietz; A Gavazzi; R Hobbs; J Korewicki; H C Madeira; V S Moiseyev; I Preda; W H van Gilst; J Widimsky; N Freemantle; Joanne Eastaugh; J Mason Journal: Eur Heart J Date: 2003-03 Impact factor: 29.983