December 14, 2013European Journal of Heart Failure
The Relationship between Left Ventricular Ejection Fraction and Mortality in Patients with Acute Heart Failure: Insights from the ASCEND-HF Trial
Key result
In patients with acute decompensated heart failure, 180-day mortality was similar between low (<40%) and preserved (>50%) ejection fraction groups (HR 0.96; 95% CI 0.75-1.24; P=0.77).
Why the study?
Does left ventricular ejection fraction predict 30 and 180 day mortality in patients with acute decompensated heart failure?
Population
7,007 patients with acute decompensated heart failure (ADHF) enrolled in the ASCEND-HF trial
Comparison
Left ventricular ejection fraction < 40% or 40-50% vs LVEF > 50% (PresEF)
Design
Cohort
Follow-up
180 days
Authors
Discussion
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Member takes
Implication
Similar mortality across LVEF groups warrants caution in prognostication; leaves open adjusted risks below 35%.
Study Design
Type
Observational (n=7,007)
Structured PICO
Does left ventricular ejection fraction predict 30 and 180 day mortality in patients with acute decompensated heart failure?
P
Population
7,007 patients with acute decompensated heart failure (ADHF) enrolled in the ASCEND-HF trial
I
Intervention
Left ventricular ejection fraction (LVEF) < 40% (LowEF) or 40-50% (IntEF)
C
Comparator
LVEF > 50% (PresEF)
O
Outcome
30 and 180 day mortalityhard clinical
Main Result
Effect estimate: HR 0.96 (95% CI 0.75-1.24)
Absolute Event Rate: 12.3% vs 14.1%
p-value: p=0.77
In patients with acute decompensated heart failure, unadjusted mortality rates are similar across LVEF strata, but after adjusting for key variables, mortality risk increases as LVEF falls below 35%.
Cite This Study
Toma et al. (2013) conducted an observational in Acute decompensated heart failure (ADHF) (n=7,007). Low ejection fraction (<40%) vs. Preserved ejection fraction (>50%) was evaluated on 180-day mortality (HR 0.96, 95% CI 0.75-1.24, p=0.77). In patients with acute decompensated heart failure, 180-day mortality was similar between low (<40%) and preserved (>50%) ejection fraction groups (HR 0.96; 95% CI 0.75-1.24; P=0.77).