Acute pulmonary oedema was associated with higher in-hospital mortality compared with acutely decompensated chronic heart failure (7.4% vs. 6.0%, P=0.057).
Observational (n=4,953)
Yes
Do clinical characteristics, management, and in-hospital mortality differ between patients with acute pulmonary oedema and acutely decompensated chronic heart failure?
Acute pulmonary oedema presents with a distinct clinical profile, including higher admission blood pressure and LVEF, and tends to have higher in-hospital mortality compared to acutely decompensated chronic heart failure.
Absolute Event Rate: 7.4% vs 6%
p-value: p=0.057
AIMS: Acute pulmonary oedema (APE) is the second, after acutely decompensated chronic heart failure (ADHF), most frequent form of acute heart failure (AHF). This subanalysis examines the clinical profile, prognostic factors, and management of APE patients (n = 1820, 36.7%) included in the Acute Heart Failure Global Survey of Standard Treatment (ALARM-HF). METHODS AND RESULTS: ALARM-HF included a total of 4953 patients hospitalized for AHF in Europe, Latin America, and Australia. The final diagnosis was made at discharge, and patients were classified according to European Society of Cardiology guidelines. Patients with APE had higher in-hospital mortality (7.4 vs. 6.0%, P = 0.057) compared with ADHF patients (n = 1911, 38.5%), and APE patients exhibited higher systolic blood pressures (P < 0.001) at admission and higher left ventricular ejection fraction (LVEF, P < 0.01) than those with ADHF. These patients also had a higher prevalence of diabetes (P < 0.01), arterial hypertension (P < 0.001), peripheral vascular disease (P < 0.001), and chronic renal disease (P < 0.05). They were also more likely to receive intravenous (i.v.) diuretics (P < 0.001), i.v. nitrates (P < 0.01), dopamine (P < 0.05), and non-invasive ventilation (P < 0.001). Low systolic blood pressure (P < 0.001), low LVEF (<0.05), serum creatinine ≥1.4 mg/dL (P < 0.001), history of cardiomyopathy (P < 0.05), and previous cardiovascular event (P < 0.001) were independently associated with increased in-hospital mortality in the APE population. CONCLUSION: APE differs in clinical profile, in-hospital management, and mortality compared with ADHF. Admission characteristics (systolic blood pressure and LVEF), renal function, and history may identify high-risk APE patients.
Parissis et al. (2010) conducted an observational in Acute pulmonary oedema (APE) and acutely decompensated chronic heart failure (ADHF) (n=4,953). Acute pulmonary oedema (APE) vs. Acutely decompensated chronic heart failure (ADHF) was evaluated on In-hospital mortality (p=0.057). Acute pulmonary oedema was associated with higher in-hospital mortality compared with acutely decompensated chronic heart failure (7.4% vs. 6.0%, P=0.057).