October 26, 2015Open Access
Mode of Death After Acute Heart Failure Hospitalization – A Clue to Possible Mechanisms –
Key Result
Hospitalization for acute heart failure is associated with a dramatic increase in mortality risk, remaining 3-4-fold higher at 12-18 months post-discharge compared to stable ambulatory patients.
Structured PICO
P
Population
Patients hospitalized for acute heart failure (AHF)
This review highlights that post-discharge mortality in acute heart failure remains high, primarily driven by heart failure progression and sudden cardiac death, emphasizing the need for targeted therapies addressing congestion and end-organ damage.
Main Result
Effect estimate: 3-4-fold higher
Abstract
increased to 17.4% and 43.9%, respectively, in patients hospitalized for AHF. ongitudinal prospective clinical trials have shown similar results. Compared with stable ambulatory patients, patients hospitalized for HF show a dramatic increase in their risk of dying and this is independent of the baseline ejection fraction (EF), with no difference between patients with reduced EF (HFrEF) and those with preserved EF (HFpEF). 15-17 This risk of death decreases exponentially in the months following discharge, but remains 3-4-fold higher even at 12-18 months after the initial hospitalization. 15,18,19 HF hospitalizations are therefore associated with an increased risk of long-term death, too, and this effect on patients' prognosis is similar to that described for acute coronary syndrome or stroke. 17,18 Thus, improving post-discharge mortality risk in AHF patients remains a major unmet need in current clinical practice. A better understanding of the modes of death (MOD) of AHF patients may lead to better insights and new treatments.