Predictors of long-term survival in patients with a first episode of acute heart failure

Introduction: Acute heart failure (AHF) represents a critical event in heart failure progression, but data on long-term outcomes after first hospitalization remain scarce. The aim is to describe long-term survival and evaluate its predictors after the first episode of AHF. Material and methods: Pati...

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Detalles Bibliográficos
Autores: Romero, Carlos|||0009-0002-1803-6303, Alquézar-Arbé, A.|||0000-0003-4164-274X, Núñez, Julio|||0000-0003-1672-7119, Gil, Víctor, Jacob, Javier|||0000-0003-1101-1066, Aguirre, Alfons, Villarejo Jiménez, Ana|||0009-0005-7996-9387, Borja, María|||0009-0001-3119-8967, De la Espriella, Rafael|||0000-0002-8720-3999, Santas, Enrique, Sánchez, Carolina|||0000-0002-5408-1016, Repullo, Daniel, Fuentes, Lidia, Anaya Bustos, Sara, Miñana, Gema|||0000-0001-8777-2588, Llorens Soriano, Pere|||0000-0002-9291-7179, Miró, Oscar|||0000-0002-7924-9751
Tipo de recurso: artículo
Fecha de publicación:2025
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:dnet:uabarcelona_::59c3a6fd1b2993a79802d2fe4fd82852
Acceso en línea:https://ddd.uab.cat/record/327058
https://dx.doi.org/urn:doi:10.33963/v.phj.107033
Access Level:acceso abierto
Palabra clave:Acute heart failure
Long-term survival
Mortality
Outcome
Descripción
Sumario:Introduction: Acute heart failure (AHF) represents a critical event in heart failure progression, but data on long-term outcomes after first hospitalization remain scarce. The aim is to describe long-term survival and evaluate its predictors after the first episode of AHF. Material and methods: Patients from five Spanish hospitals with a confirmed first diagnosis of AHF were categorized based on survival (≥5 or <5 years). Thirteen independent variables were identified. Mortality was assessed using Kaplan-Meier curves after up to 10 years of follow-up. Adjusted odds ratios (OR) with 95% confidence intervals (CI) for mortality were calculated. Additionally, adjusted survival probabilities according to patient age and left ventricular ejection fraction (LVEF) were obtained using restricted cubic splines. Results: A total of 1986 patients were included, with a median age 76 years (range: 68-82), 50% women, and 57% with preserved LVEF. Five-year mortality was 52%. Adjusted analysis showed that age (OR, 0.470 per 10-year increment; 95% CI, 0.421-0.525), New York Heart Association class III-IV vs. I (OR, 0.476; 95% CI, 0.341-0.666) and II vs. I (OR, 0.780; 95% CI, 0.627-0.969), chronic kidney disease (OR, 0.609; 95% CI, 0.452-0.820), coronary artery disease (OR, 0.657; 95% CI, 0.523-0.824), diabetes mellitus (OR, 0.658; 95% CI, 0.534-0.811), and male sex (OR, 0.774; 95% CI, 0.625-0.958) were associated with death within 5 years. LVEF at inclusion was not related to 5-year survival. Conclusions: Survival after a first AHF episode is poor, with age, NewYork Heart Association class, kidney function, coronary artery disease, diabetes, and sex being key predictors of long-term mortality.

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