Association of Heart Failure Categorized by Ejection Fraction with In-Hospital and Cardiovascular Mortality among Patients with Acute Decompensated Heart Failure

INTRODUCTION Ejection fraction (EF) is a powerful prognosticator for heart failure (HF). Acute heart failure (AHF) may either be new onset or acute decompensated heart failure (ADHF). Studies were inconsistent on the association of HF categorized by EF with mortality among AHF patients particularly ADHF. METHODS A retrospective cohort study of ADHF patients enrolled in the national Philippine Heart Association AHF registry was conducted. Patients with de novo HF were excluded. Binary logistic regression analysis was done. RESULTS From 1123 patients with AHF, 460 patients (41%) were diagnosed with ADHF. Heart failure reduced EF (HFrEF) was the most common classification (50%), followed by heart failure preserved EF (HFpEF 31%), and heart failure mildly reduced EF (HFmrEF 18%). The mean age was 56 years. Majority has no identifiable precipitating factors for decompensation. In-hospital mortality occurred in 11 patients (2.72%) with cardiovascular mortality as the major cause of death. On adjusted analysis, the odds of dying for HFrEF and HFmrEF was 7x (OR adj= 6.7; 95% CI 0.65-64.35) and 3x (OR adj=3.29 95% CI 0.15- 70.60) respectively compared to the odds of dying in HFpEF. However, this result was not statistically significant. CONCLUSION Although there was a trend for higher odds of dying for HFrEF and HFmrEF as compared to HFpEF, but the study did not show statistical significance.