Synapse
⌘+K
Synapse
PulseExploreClubsResearchersJournals
Instagram
HomeClubsExplore
August 24, 2026Journal of the American College of CardiologyOpen Access

Hospitalization for Recently Diagnosed Versus Worsening Chronic Heart Failure

View Full Paper
Ask AI
Bookmark
Share

Key result

Longer HF duration is linked to a ~102% increase in 180-day mortality.

  • HR 2.02
  • 95% CI 1.47-2.77
  • n=5,741

Why the study?

It was unclear how patients hospitalized for acute HF who are long-term chronic HF survivors differ from those with more recent HF diagnoses.

Does longer duration of heart failure diagnosis worsen early dyspnea relief and 180-day mortality in patients hospitalized for acute heart failure compared to recently diagnosed heart failure?

Population

5,741 hospitalized acute HF patients with documentation of HF duration from the ASCEND-HF trial

Comparison

HF duration 0 to 1 month vs >1 to 12 months vs >12 to 60 months vs >60 months

Design

Post-hoc analysis of a randomized placebo-controlled trial

Follow-up

180-day

Authors

SGStephen J. GreeneAHAdrian F. HernandezADAllison Dunning

Discussion

Loading...

Member takes

Overview

Recent HF diagnosis was associated with better dyspnea relief and survival; leaves open whether chronicity should stratify acute HF trials or risk models.

Key Points

  • To evaluate how heart failure chronicity affects baseline clinical profiles, symptom relief, and 180-day post-discharge mortality in patients hospitalized for acute heart failure.
  • Analysis of the randomized ASCEND-HF trial (NCT00475852), which evaluated 7,141 patients with acute heart failure receiving nesiritide or placebo alongside standard care.
  • Categorized 5,741 patients with documented diagnosis duration into four groups: 0 to 1 month (n=1,536), >1 to 12 months (n=1,020), >12 to 60 months (n=1,653), and >60 months (n=1,532).
  • Compared patient characteristics, persistent dyspnea at 24 hours, and 180-day all-cause mortality using multivariable regression models.
  • Patients with chronic diagnoses experienced higher rates of persistent dyspnea at 24 hours compared to recently diagnosed patients (>1 to 12 months, OR: 1.20, 95% CI: 0.97–1.48; >12 to 60 months, OR: 1.34, 95% CI: 1.11–1.62; >60 months, OR: 1.31, 95% CI: 1.08–1.60).
  • Longer duration of heart failure diagnosis was independently associated with increased 180-day mortality compared to recent diagnosis (>1 to 12 months, HR: 1.89, 95% CI: 1.35–2.65; >12 to 60 months, HR: 1.82, 95% CI: 1.33–2.48; >60 months, HR: 2.02, 95% CI: 1.47–2.77), with a stronger effect observed in women (interaction P=0.05).

Study Design

Type

RCT (n=5,741)

Blinding

placebo-controlled

Randomization

randomized

Structured PICO

Does longer duration of heart failure diagnosis worsen early dyspnea relief and 180-day mortality in patients hospitalized for acute heart failure compared to recently diagnosed heart failure?

P
Population
5,741 hospitalized patients with acute heart failure with reduced or preserved ejection fraction, analyzed by duration of prior heart failure diagnosis and followed for 180 days.
I
Intervention
Longer duration of chronic heart failure diagnosis (>1 to 12 months, >12 to 60 months, and >60 months prior to index hospitalization).
C
Comparator
Recently diagnosed heart failure (0 to 1 month prior to index hospitalization).
O
Outcome
Dyspnea relief at 24 hours and 180-day mortality.hard clinical

Main Result

Hazard Ratio: 2.02 (95% CI 1.47–2.77)

Patients hospitalized for acute heart failure with a recent diagnosis (≤1 month) have better early dyspnea relief and post-discharge survival compared to those with chronic heart failure.

Cite This Study

Greene et al. (2017) conducted an RCT in Acute heart failure (n=5,741). Longer duration of heart failure diagnosis (>60 months) vs. Recently diagnosed heart failure (≤1 month) was evaluated on 180-day mortality (HR 2.02, 95% CI 1.47-2.77). Longer duration of heart failure diagnosis (>60 months vs ≤1 month) was associated with increased 180-day mortality (HR 2.02; 95% CI 1.47-2.77).

synapsesocial.com/papers/6a8c60d9133d286cb12e2b46https://doi.org/10.1016/j.jacc.2017.04.043
View Full Paper
Ask AI
Bookmark
Share

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Influence of Nonfatal Hospitalization for Heart Failure on Subsequent Mortality in Patients With Chronic Heart Failure2007 · 685 citations
  2. 2Importance of Clinical Worsening of Heart Failure Treated in the Outpatient Setting2016 · 185 citations
  3. 3Influence of Documented History of Coronary Artery Disease on Outcomes in Patients Admitted for Worsening Heart Failure with Reduced Ejection Fraction in the EVEREST Trial2012 · 27 citations
  4. 4Effect of Vericiguat, a Soluble Guanylate Cyclase Stimulator, on Natriuretic Peptide Levels in Patients With Worsening Chronic Heart Failure and Reduced Ejection Fraction2015 · 395 citations
  5. 5Trends in Prevalence and Outcome of Heart Failure with Preserved Ejection Fraction2006 · 4,231 citations