Impact of identifying precipitating factors on 30-day mortality in acute heart failure patients

Background: The aim of this study was to describe the prevalence and prognostic value of the most common triggering factors in acute heart failure. Methods: Patients with acute heart failure from 41 Spanish emergency departments were recruited consecutively in three time periods between 2011 and 201...

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Autores: Rossello, X, Gil, V, Escoda, R, Jacob, J, Aguirre, A, Martin-Sanchez, FJ, Llorens, P, Puente, PH, Rizzi, M, Raposeiras-Roubin, S, Wussler, D, Muller, CE, Gayat, E, Mebazaa, A, Miro, O, Fuentes, M, Gil, C, Alonso, H, Perez-Llantada, E, Garcia, GL, Cadenas, MS, Xipell, C, Sanchez, C, Perez-Dura, MJ, Salvo, E, Pavon, J, Noval, A, Tones, JM, Lopez-Grima, ML, Valero, A, Juan, MA, Pedragosa, MA, Maso, SM, Alonso, MI, Ruiz, F, Franco, JM, Mecina, AB, Tost, J, Berenguer, M, Donea, R, Ramon, SS, Rodriguez, VC, Pinera, P, Nicolas, JAS, Garate, RT, Alquezar-Arbe, A, Rizzi, MA, Herrera, S, Roset, A, Cabello, I, Haro, A, Richard, F, Perez, JMA, Diez, MPL, Alvarez, JV, Garcia, BP, Garcia, MG, Gonzalez, MS, Javaloyes, P, Marquina, V, Jimenez, I, Hernandez, N, Brouzet, B, Espinosa, B, Andueza, JA, Romero, R, Ruiz, M, Calvache, R, Serralta, MTL, Jave, LEC, Arriaga, BA, Bergua, BS, Mojarro, EM, Jimenez, BSA, Becquer, LT, Burillo, G, Garcia, LL, LaSalle, GC, Urbano, CA, Soto, ABG, Padial, ED, Ferrer, ES, Garrido, JM, Lucas-Imbernon, FJ, Gaya, R, Bibiano, C, Mir, M, Rodriguez, B, Carballo, JL, Rodriguez-Adrada, E, Miranda, BR
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2019
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p13773
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=13773
Access Level:acceso abierto
Palabra clave:Acute heart failure
precipitant factors
mortality
outcome
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spelling Impact of identifying precipitating factors on 30-day mortality in acute heart failure patientsRossello, XGil, VEscoda, RJacob, JAguirre, AMartin-Sanchez, FJLlorens, PPuente, PHRizzi, MRaposeiras-Roubin, SWussler, DMuller, CEGayat, EMebazaa, AMiro, OFuentes, MGil, CAlonso, HPerez-Llantada, EMartin-Sanchez, FJGarcia, GLCadenas, MSXipell, CSanchez, CPerez-Dura, MJSalvo, EPavon, JNoval, ATones, JMLopez-Grima, MLValero, AJuan, MAPedragosa, MAMaso, SMAlonso, MIRuiz, FFranco, JMMecina, ABTost, JBerenguer, MDonea, RRamon, SSRodriguez, VCPinera, PNicolas, JASGarate, RTAlquezar-Arbe, ARizzi, MAHerrera, SRoset, ACabello, IHaro, ARichard, FPerez, JMADiez, MPLAlvarez, JVGarcia, BPGarcia, MGGonzalez, MSJavaloyes, PMarquina, VJimenez, IHernandez, NBrouzet, BEspinosa, BAndueza, JARomero, RRuiz, MCalvache, RSerralta, MTLJave, LECArriaga, BABergua, BSMojarro, EMJimenez, BSABecquer, LTBurillo, GGarcia, LLLaSalle, GCUrbano, CASoto, ABGPadial, EDFerrer, ESGarrido, JMLucas-Imbernon, FJGaya, RBibiano, CMir, MRodriguez, BCarballo, JLRodriguez-Adrada, EMiranda, BRAcute heart failureprecipitant factorsmortalityoutcomeBackground: The aim of this study was to describe the prevalence and prognostic value of the most common triggering factors in acute heart failure. Methods: Patients with acute heart failure from 41 Spanish emergency departments were recruited consecutively in three time periods between 2011 and 2016. Precipitating factors were classified as: (a) unrecognized; (b) infection; (c) atrial fibrillation; (d) anaemia; (e) hypertension; (f) acute coronary syndrome; (g) non-adherence; and (h) two or more precipitant factors. Unadjusted and adjusted logistic regression models were used to assess the association between 30-day mortality and each precipitant factor. The risk of dying was further evaluated by week intervals over the 30-day follow-up to assess the period of higher vulnerability for each precipitant factor. Results: Approximately 69% of our 9999 patients presented with a triggering factor and 1002 died within the first 30 days (10.0%). The most prevalent factors were infection and atrial fibrillation. After adjusting for 11 known predictors, acute coronary syndrome was associated with higher 30-day mortality (odds ratio (OR) 1.87; 95% confidence interval (CI) 1.02-3.42), whereas atrial fibrillation (OR 0.75; 95% CI 0.56-0.94) and hypertension (OR 0.34; 95% CI 0.21-0.55) were significantly associated with better outcomes when compared to patients without precipitant. Patients with infection, anaemia and non-compliance were not at higher risk of dying within 30 days. These findings were consistent across gender and age groups. The 30-day mortality time pattern varied between and within precipitant factors. Conclusions: Precipitant factors in acute heart failure patients are prevalent and have a prognostic value regardless of the patient's gender and age. They can be managed with specific treatments and can sometimes be prevented.SAGE PUBLICATIONS LTD2019info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=13773European Heart Journal-Acute Cardiovascular CareISSN: 20488726ISSNe: 20488734reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Inglésinfo:eu-repo/semantics/openAccessoai:iibsantpau.fundanetsuite.com:p137732026-06-14T12:41:47Z
dc.title.none.fl_str_mv Impact of identifying precipitating factors on 30-day mortality in acute heart failure patients
title Impact of identifying precipitating factors on 30-day mortality in acute heart failure patients
spellingShingle Impact of identifying precipitating factors on 30-day mortality in acute heart failure patients
Rossello, X
Acute heart failure
precipitant factors
mortality
outcome
title_short Impact of identifying precipitating factors on 30-day mortality in acute heart failure patients
title_full Impact of identifying precipitating factors on 30-day mortality in acute heart failure patients
title_fullStr Impact of identifying precipitating factors on 30-day mortality in acute heart failure patients
title_full_unstemmed Impact of identifying precipitating factors on 30-day mortality in acute heart failure patients
title_sort Impact of identifying precipitating factors on 30-day mortality in acute heart failure patients
dc.creator.none.fl_str_mv Rossello, X
Gil, V
Escoda, R
Jacob, J
Aguirre, A
Martin-Sanchez, FJ
Llorens, P
Puente, PH
Rizzi, M
Raposeiras-Roubin, S
Wussler, D
Muller, CE
Gayat, E
Mebazaa, A
Miro, O
Fuentes, M
Gil, C
Alonso, H
Perez-Llantada, E
Martin-Sanchez, FJ
Garcia, GL
Cadenas, MS
Xipell, C
Sanchez, C
Perez-Dura, MJ
Salvo, E
Pavon, J
Noval, A
Tones, JM
Lopez-Grima, ML
Valero, A
Juan, MA
Pedragosa, MA
Maso, SM
Alonso, MI
Ruiz, F
Franco, JM
Mecina, AB
Tost, J
Berenguer, M
Donea, R
Ramon, SS
Rodriguez, VC
Pinera, P
Nicolas, JAS
Garate, RT
Alquezar-Arbe, A
Rizzi, MA
Herrera, S
Roset, A
Cabello, I
Haro, A
Richard, F
Perez, JMA
Diez, MPL
Alvarez, JV
Garcia, BP
Garcia, MG
Gonzalez, MS
Javaloyes, P
Marquina, V
Jimenez, I
Hernandez, N
Brouzet, B
Espinosa, B
Andueza, JA
Romero, R
Ruiz, M
Calvache, R
Serralta, MTL
Jave, LEC
Arriaga, BA
Bergua, BS
Mojarro, EM
Jimenez, BSA
Becquer, LT
Burillo, G
Garcia, LL
LaSalle, GC
Urbano, CA
Soto, ABG
Padial, ED
Ferrer, ES
Garrido, JM
Lucas-Imbernon, FJ
Gaya, R
Bibiano, C
Mir, M
Rodriguez, B
Carballo, JL
Rodriguez-Adrada, E
Miranda, BR
author Rossello, X
author_facet Rossello, X
Gil, V
Escoda, R
Jacob, J
Aguirre, A
Martin-Sanchez, FJ
Llorens, P
Puente, PH
Rizzi, M
Raposeiras-Roubin, S
Wussler, D
Muller, CE
Gayat, E
Mebazaa, A
Miro, O
Fuentes, M
Gil, C
Alonso, H
Perez-Llantada, E
Garcia, GL
Cadenas, MS
Xipell, C
Sanchez, C
Perez-Dura, MJ
Salvo, E
Pavon, J
Noval, A
Tones, JM
Lopez-Grima, ML
Valero, A
Juan, MA
Pedragosa, MA
Maso, SM
Alonso, MI
Ruiz, F
Franco, JM
Mecina, AB
Tost, J
Berenguer, M
Donea, R
Ramon, SS
Rodriguez, VC
Pinera, P
Nicolas, JAS
Garate, RT
Alquezar-Arbe, A
Rizzi, MA
Herrera, S
Roset, A
Cabello, I
Haro, A
Richard, F
Perez, JMA
Diez, MPL
Alvarez, JV
Garcia, BP
Garcia, MG
Gonzalez, MS
Javaloyes, P
Marquina, V
Jimenez, I
Hernandez, N
Brouzet, B
Espinosa, B
Andueza, JA
Romero, R
Ruiz, M
Calvache, R
Serralta, MTL
Jave, LEC
Arriaga, BA
Bergua, BS
Mojarro, EM
Jimenez, BSA
Becquer, LT
Burillo, G
Garcia, LL
LaSalle, GC
Urbano, CA
Soto, ABG
Padial, ED
Ferrer, ES
Garrido, JM
Lucas-Imbernon, FJ
Gaya, R
Bibiano, C
Mir, M
Rodriguez, B
Carballo, JL
Rodriguez-Adrada, E
Miranda, BR
author_role author
author2 Gil, V
Escoda, R
Jacob, J
Aguirre, A
Martin-Sanchez, FJ
Llorens, P
Puente, PH
Rizzi, M
Raposeiras-Roubin, S
Wussler, D
Muller, CE
Gayat, E
Mebazaa, A
Miro, O
Fuentes, M
Gil, C
Alonso, H
Perez-Llantada, E
Garcia, GL
Cadenas, MS
Xipell, C
Sanchez, C
Perez-Dura, MJ
Salvo, E
Pavon, J
Noval, A
Tones, JM
Lopez-Grima, ML
Valero, A
Juan, MA
Pedragosa, MA
Maso, SM
Alonso, MI
Ruiz, F
Franco, JM
Mecina, AB
Tost, J
Berenguer, M
Donea, R
Ramon, SS
Rodriguez, VC
Pinera, P
Nicolas, JAS
Garate, RT
Alquezar-Arbe, A
Rizzi, MA
Herrera, S
Roset, A
Cabello, I
Haro, A
Richard, F
Perez, JMA
Diez, MPL
Alvarez, JV
Garcia, BP
Garcia, MG
Gonzalez, MS
Javaloyes, P
Marquina, V
Jimenez, I
Hernandez, N
Brouzet, B
Espinosa, B
Andueza, JA
Romero, R
Ruiz, M
Calvache, R
Serralta, MTL
Jave, LEC
Arriaga, BA
Bergua, BS
Mojarro, EM
Jimenez, BSA
Becquer, LT
Burillo, G
Garcia, LL
LaSalle, GC
Urbano, CA
Soto, ABG
Padial, ED
Ferrer, ES
Garrido, JM
Lucas-Imbernon, FJ
Gaya, R
Bibiano, C
Mir, M
Rodriguez, B
Carballo, JL
Rodriguez-Adrada, E
Miranda, BR
author2_role author
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author
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author
author
author
author
author
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author
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dc.subject.none.fl_str_mv Acute heart failure
precipitant factors
mortality
outcome
topic Acute heart failure
precipitant factors
mortality
outcome
description Background: The aim of this study was to describe the prevalence and prognostic value of the most common triggering factors in acute heart failure. Methods: Patients with acute heart failure from 41 Spanish emergency departments were recruited consecutively in three time periods between 2011 and 2016. Precipitating factors were classified as: (a) unrecognized; (b) infection; (c) atrial fibrillation; (d) anaemia; (e) hypertension; (f) acute coronary syndrome; (g) non-adherence; and (h) two or more precipitant factors. Unadjusted and adjusted logistic regression models were used to assess the association between 30-day mortality and each precipitant factor. The risk of dying was further evaluated by week intervals over the 30-day follow-up to assess the period of higher vulnerability for each precipitant factor. Results: Approximately 69% of our 9999 patients presented with a triggering factor and 1002 died within the first 30 days (10.0%). The most prevalent factors were infection and atrial fibrillation. After adjusting for 11 known predictors, acute coronary syndrome was associated with higher 30-day mortality (odds ratio (OR) 1.87; 95% confidence interval (CI) 1.02-3.42), whereas atrial fibrillation (OR 0.75; 95% CI 0.56-0.94) and hypertension (OR 0.34; 95% CI 0.21-0.55) were significantly associated with better outcomes when compared to patients without precipitant. Patients with infection, anaemia and non-compliance were not at higher risk of dying within 30 days. These findings were consistent across gender and age groups. The 30-day mortality time pattern varied between and within precipitant factors. Conclusions: Precipitant factors in acute heart failure patients are prevalent and have a prognostic value regardless of the patient's gender and age. They can be managed with specific treatments and can sometimes be prevented.
publishDate 2019
dc.date.none.fl_str_mv 2019
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=13773
url https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=13773
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv SAGE PUBLICATIONS LTD
publisher.none.fl_str_mv SAGE PUBLICATIONS LTD
dc.source.none.fl_str_mv European Heart Journal-Acute Cardiovascular Care
ISSN: 20488726
ISSNe: 20488734
reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
instname_str Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
reponame_str r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
collection r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
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repository.mail.fl_str_mv
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