Key result
Admission NT-proBNP, comorbidities, and higher LVEF independently predict 1-year mortality or HF rehospitalization after acute HF.
Why the study?
Acute heart failure carries high mortality and rehospitalization rates, but contemporary real-world data from cardiology departments are scarce.
Cohort (n=602)
Open-label
Yes
In patients hospitalized with acute heart failure, prognosis is heavily driven by comorbidity burden and admission NT-proBNP, while comprehensive implementation of guideline-directed medical therapy at discharge significantly improves outcomes in HFrEF.
May support admission-based risk stratification in acute HF; hypothesis-generating for targeted interventions.
Introduction and objectives: Acute heart failure (AHF) is the leading cardiovascular cause of hospitalization and remains associated with high mortality and rehospitalization rates. Contemporary real-world data from cardiology departments are scarce. We aimed to identify admission characteristics associated with one-year outcomes in patients hospitalized with AHF. Methods: RECYLICA is a prospective, multicentre, regional registry including consecutive patients admitted with AHF to cardiology departments across 10 hospitals over a one-year period. Patients were followed for 12 months. The primary endpoint was the composite of all-cause mortality or heart failure (HF) rehospitalization. Results: A total of 602 patients were included (37.0% women; mean age 72.6 ± 12.0 years), of whom 47.4% had heart failure with reduced left ventricular ejection fraction (HFrEF). During follow-up, 83 patients (13.8%) died and 105 (17.4%) were rehospitalized because of HF. Independent predictors of the primary endpoint were elevated admission N-terminal pro-B-type natriuretic peptide (NT-proBNP), atrial fibrillation (AF), chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), previous HF, prior implantable cardioverter-defibrillator (ICD) implantation, and higher left ventricular ejection fraction (LVEF). Among patients with HFrEF, less comprehensive implementation of guideline-directed medical therapy (GDMT) at discharge was associated with significantly worse outcomes. Conclusions: In patients hospitalized with AHF, prognosis is primarily determined by comorbidity burden, admission NT-proBNP levels, previous HF, and LVEF. Among patients with HFrEF, more comprehensive implementation of GDMT at discharge was associated with improved clinical outcomes, supporting early optimization of evidence-based therapy during hospitalization.
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Nogueira et al. (2026) conducted a cohort in Acute heart failure (AHF) (n=602). Prognostic factors (comorbidities, NT-proBNP, previous HF, LVEF) was evaluated on Composite of all-cause mortality or heart failure rehospitalization. In patients hospitalized with acute heart failure, independent predictors of 1-year mortality or HF rehospitalization included elevated admission NT-proBNP, atrial fibrillation, CKD, COPD, previous HF, prior ICD, and higher LVEF.