The Real World of de novo Heart Failure: The Next Frontier for Heart Failure Clinical Trials?
Key result
Among 17,176 hospitalized patients, worsening chronic heart failure (48%) was associated with a substantially higher rate of mortality and readmission compared to new-onset heart failure (52%).
Why the study?
Does new-onset HF compared to worsening chronic HF reduce all-cause mortality and HF readmission in patients hospitalized for heart failure?
Population
17,176 patients at first hospital admission for HF in the period 2013–2015 using data from Danish nationwide…
Comparison
New-onset HF vs Worsening of chronic HF
Design
Editorial
Authors
Discussion
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Member takes
Implication
De novo heart failure is associated with better outcomes than worsening chronic heart failure, highlighting its potential as a distinct population for future clinical trials and implementation research.
Key Points
- To evaluate clinical differences in readmission and mortality between de novo and worsening chronic heart failure, and assess the implications for future clinical trial designs.
- Analyzed an unselected nationwide cohort of 17,176 patients presenting at their first hospital admission for heart failure in Denmark between 2013 and 2015.
- Categorized patients into new-onset heart failure (history ≤30 days, n = 8,860) or worsening chronic heart failure (history >30 days, n = 8,316) using up to 10 years of prior inpatient and outpatient registry data.
- New-onset heart failure accounted for 52% (n = 8,860) of admissions, while worsening chronic heart failure comprised 48% (n = 8,316).
- Worsening chronic heart failure was independently associated with a significantly higher rate of all-cause mortality and heart failure readmission relative to new-onset heart failure.
- Comorbid atrial fibrillation was associated with a better prognosis in de novo heart failure, but correlated with worse outcomes in worsening chronic heart failure.
Structured PICO
Does new-onset HF compared to worsening chronic HF reduce all-cause mortality and HF readmission in patients hospitalized for heart failure?
P
Population
17,176 patients at first hospital admission for heart failure in Denmark between 2013 and 2015, comparing new-onset versus worsening chronic heart failure.
E
Exposure
New-onset HF (defined as either no history of HF or a history of HF of ≤30 days)
C
Comparator
Worsening of chronic HF (defined as a history of HF of >30 days)
O
Outcome
All-cause mortality and HF readmissionhard clinical
De novo heart failure is associated with better outcomes than worsening chronic heart failure, highlighting its potential as a distinct population for future clinical trials and implementation research.
Cite This Study
Khan et al. (2020) conducted an editorial in Heart Failure (n=17,176). Worsening chronic heart failure vs. New-onset heart failure was evaluated on All-cause mortality and heart failure readmission. Among 17,176 hospitalized patients, worsening chronic heart failure (48%) was associated with a substantially higher rate of mortality and readmission compared to new-onset heart failure (52%).