Clinical factors associated with 30-day heart failure readmission in patients with acute decompensated heart failure with preserved ejection fraction

Background: In acute decompensated heart failure with preserved ejection fraction (ADHFpEF), residual congestion before discharge is closely related to early heart failure (HF) readmission. This study evaluated the clinical factors associated with 30-day HF readmission in patients with ADHFpEF. Methods: This single-center retrospective study included 312 adults discharged after hospitalization for ADHFpEF between January 2020 and December 2024. Clinical, laboratory, echocardiographic, medication, and follow-up data were obtained from the medical records. Factors associated with 30-day HF readmission were evaluated using univariable and multivariable logistic regression analyses. Medication adherence was assessed using the Chinese version of the Adherence to Refills and Medications Scale (ARMS-C). Sensitivity analyses addressed coronavirus disease 2019 (COVID-19)-related calendar periods and chronic obstructive pulmonary disease (COPD). Results: Thirty-day HF readmission occurred in 62 patients (19.9%). Adherence and sensitivity analyses were consistent with the primary findings. Conclusions: In patients with ADHFpEF, several clinical factors were associated with 30-day HF readmission. Identification of these factors may support early risk assessment and individualized post-discharge management.