Key result
In-hospital mortality did not differ significantly between acute decompensated heart failure patients with preserved versus reduced ejection fraction (12.5% vs 7.7%, p=0.423).
Why the study?
ADHF has a rising prevalence in India with earlier onset and high mortality, but comparative data on patients with preserved versus reduced ejection fraction were lacking.
Do clinical profiles and in-hospital mortality differ between acute decompensated heart failure patients with preserved versus reduced ejection fraction?
Cross-Sectional (n=100)
No
Do clinical profiles and in-hospital mortality differ between acute decompensated heart failure patients with preserved versus reduced ejection fraction?
Absolute Event Rate: 12.5% vs 7.69%
p-value: p=0.423
Despite significant differences in clinical and biochemical profiles between patients with preserved and reduced ejection fraction, in-hospital mortality in acute decompensated heart failure does not differ significantly.
Background Acute decompensated heart failure (ADHF) is a major global health concern with rising prevalence in India, marked by earlier onset, high mortality, and frequent hospitalizations. This study aims to compare the risk factors, clinical and biochemical profiles, and in-hospital outcomes of ADHF patients with preserved versus reduced ejection fraction, addressing a key gap in Indian data. Materials and methods A cross-sectional observational study was conducted in the Department of Medicine at MM Institute of Medical Sciences and Research, Mullana, enrolling 100 consecutive patients aged ≥18 years with a confirmed diagnosis of heart failure according to the American College of Cardiology/American Heart Association/Heart Failure Society of America (2022 guidelines) (ACC/AHA/HFSA) 2022 definition. Patients with congenital heart disease, chronic cor pulmonale, or rheumatic heart disease were excluded. After informed consent, all participants underwent detailed history-taking, clinical examination, and investigations, and were followed until discharge or death. Data were analyzed using SPSS v26.0 with descriptive and inferential statistics, with p < 0.05 considered statistically significant. Results Overall, 52% of patients had heart failure with reduced ejection fraction (HFrEF) and 48% had heart failure with preserved ejection fraction (HFpEF), with a male predominance and a mean age of 62.3 years. Anemia and sepsis were common precipitating factors, while hypertension, obesity, and chronic obstructive pulmonary disease (COPD) were more associated with preserved ejection fraction (EF). In-hospital mortality was 10%. Elevated total leukocyte count (TLC), N-terminal pro-B-type natriuretic peptide (NT-proBNP), serum creatinine, and shock were significantly linked to poorer outcomes, with creatinine emerging as a strong predictor of mortality. Conclusion This study highlights the diverse clinico-biochemical profile of ADHF patients and the high prevalence of comorbidities. Significant differences were observed between preserved and reduced EF groups. Despite these variations, in-hospital mortality did not differ significantly, emphasizing the need for comprehensive risk assessment beyond ejection fraction to guide timely, individualized management in ADHF.
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Gupta et al. (2025) conducted a cross-sectional in Acute Decompensated Heart Failure (n=100). Preserved ejection fraction (HFpEF) vs. Reduced ejection fraction (HFrEF) was evaluated on In-hospital mortality (p=0.423). In-hospital mortality did not differ significantly between acute decompensated heart failure patients with preserved versus reduced ejection fraction (12.5% vs 7.7%, p=0.423).
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