Meeting the HFA-ESC advanced heart failure definition predicted higher 1-year all-cause mortality or HF hospitalization (69.3% vs 41.8%; adjusted HR 1.98, 95% CI 1.57-2.50, P<0.001).
Cohort (n=1,149)
Yes
Does meeting the 2018 HFA-ESC definition of advanced heart failure predict all-cause mortality or HF hospitalization in high-risk HF patients?
The 2018 HFA-ESC definition of advanced heart failure is a strong independent predictor of mortality and hospitalization in high-risk heart failure patients.
Hazard Ratio: 2.23 (95% CI 1.82–2.74)
Absolute Event Rate: 69.3% vs 41.8%
p-value: p=<0.001
AIMS: The Heart Failure Association of the European Society of Cardiology (HFA-ESC) proposed a definition of advanced heart failure (HF) that has not been validated, yet. We assessed its prognostic impact in a consecutive series of patients with high-risk HF. METHODS AND RESULTS: November 2021. Patients meeting the HFA-ESC advanced HF definition were compared to patients not meeting this definition. The primary endpoint was the composite of all-cause mortality or first HF hospitalization. Out of 4753 patients with HF screened, 1149 (24.3%) patients with at least one high-risk 'I NEED HELP' marker were included (mean age 75.1 ± 11.5 years, 67.3% male, median left ventricular ejection fraction LVEF 35% interquartile range 25%-50%). Among them, 193 (16.8%) patients met the HFA-ESC advanced HF definition. As compared to others, these patients were younger, had lower LVEF, higher natriuretic peptides and a worse clinical profile. The 1-year rate of the primary endpoint was 69.3% in patients with advanced HF according to the HFA-ESC definition versus 41.8% in the others (hazard ratio HR 2.23, 95% confidence interval CI 1.82-2.74, p < 0.001). The prognostic impact of the HFA-ESC advanced HF definition was confirmed after multivariable adjustment for relevant covariates (adjusted HR 1.98, 95% CI 1.57-2.50, p < 0.001). CONCLUSIONS: The HFA-ESC advanced HF definition had a strong prognostic impact in a contemporary, real-world, multicentre high-risk cohort of patients with HF.
Pagnesi et al. (Mon,) conducted a cohort in High-risk heart failure (n=1,149). HFA-ESC advanced HF definition vs. Not meeting the HFA-ESC advanced HF definition was evaluated on Composite of all-cause mortality or first HF hospitalization (HR 2.23, 95% CI 1.82-2.74, p=<0.001). Meeting the HFA-ESC advanced heart failure definition predicted higher 1-year all-cause mortality or HF hospitalization (69.3% vs 41.8%; adjusted HR 1.98, 95% CI 1.57-2.50, P<0.001).