A history of HFrEF, but not HFpEF, was an independent predictor of 7-day mortality in patients with acute pulmonary embolism (HR 2.22; 95% CI 1.25-4,38.41; P=0.021).
Cohort (n=1,055)
Yes
Does a history of HFrEF compared to HFpEF or no HF predict short-term mortality in patients with acute pulmonary embolism?
A history of HFrEF, but not HFpEF, is an independent risk factor for 7-day mortality in patients presenting with acute pulmonary embolism.
Hazard Ratio: 2.22
Absolute Event Rate: 18.5% vs 4.5%
p-value: p=0.021
AIMS: This study aimed to investigate whether the risk of short-term mortality is different in pulmonary embolism (PE) patients who have heart failure with reduced ejection fraction (HFrEF) as compared with those with heart failure with preserved ejection fraction (HFpEF). METHODS AND RESULTS: Predictive value of HFrEF or HFpEF for 7-day (intrahospital) and 30-day all-cause mortality was determined in the cohort of 1055 out of 1201 consecutive acute PE patients from the Serbian multicentre PE registry. Patients were classified into either HFrEF or HFpEF group, according to guideline-proposed criteria. A 7-day (intrahospital) and 30-day all-cause mortality was 18.5% vs. 7.3% vs. 4.5% (P < 0.001) and 22.2% vs. 16.3% vs. 7.9% (P < 0.001) for patients with the history of HFrEF, HFpEF, and without HF, respectively. Multivariable analysis adjusted to age, gender, history of chronic obstructive pulmonary disease, diabetes mellitus, arterial hypertension, presence of atrial fibrillation, and mortality risk assessment at admission has shown that only HFrEF, but not HFpEF, was an independent predictor for 7-day mortality (hazard ratio 2.22, 95% confidence interval 1.25-4,38.41, P = 0.021) and neither HFrEF or HFpEF was an independent predictor for 30-day mortality. Among various admission parameters associated to PE outcome, only systolic pressure in HFrEF patients (P < 0.001), heart rate (P = 0.01), and right ventricle systolic pressure (P = 0.039) in HFpEF patients were significantly different in patients who died compared with those who survived at 7 days. CONCLUSIONS: Our study has shown that the presence of previous history of HFrEF, but not HFpEF, in acute PE is an independent risk factor for mortality at 7 days.
Obradović et al. (Wed,) conducted a cohort in Pulmonary embolism (n=1,055). Heart failure with reduced ejection fraction (HFrEF) vs. Patients without heart failure was evaluated on 7-day (intrahospital) all-cause mortality (HR 2.22, 95% CI 1.25-4,38.41, p=0.021). A history of HFrEF, but not HFpEF, was an independent predictor of 7-day mortality in patients with acute pulmonary embolism (HR 2.22; 95% CI 1.25-4,38.41; P=0.021).