Mortality in heart failure: clinical variables of prognostic value.
Why the study?
What clinical variables and treatments predict outcome in patients with chronic heart failure?
Population
152 patients with chronic heart failure caused primarily by left ventricular dysfunction
Design
Cohort, not randomly allocated, open study
Follow-up
mean period of 21 months
Authors
Discussion
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Implication
May aid risk stratification in chronic HF; hypothesis-generating for amiodarone and requires prospective validation.
Key Points
- To evaluate clinical variables contributing to mortality in patients with chronic heart failure due to left ventricular dysfunction.
- 152 patients with chronic heart failure were followed for a mean of 21 months.
- Classic clinical variables, including treatment effects, were analyzed.
- Prognostic information was assessed through clinical evaluations without random allocation.
- Ventricular extrasystoles, no amiodarone treatment, low mean arterial pressure, and coronary artery disease were significant adverse prognostic factors.
- Initial serum potassium concentration and treadmill exercise time provided weak additional prognostic information.
- ACE inhibitors may reduce sudden death frequency, but diuretics and digoxin did not predict outcomes.
Structured PICO
What clinical variables and treatments predict outcome in patients with chronic heart failure?
P
Population
152 patients with chronic heart failure caused primarily by left ventricular dysfunction
I
Intervention
Clinical variables and clinician-determined treatments (including amiodarone, angiotensin converting enzyme inhibitors, and digoxin)
O
Outcome
Subsequent outcome (prognosis/mortality)hard clinical
In patients with chronic heart failure, frequent ventricular extrasystoles, low mean arterial pressure, coronary artery disease, and non-treatment with amiodarone independently predict poor prognosis.
Cite This Study
Cleland et al. (1987) studied this question.