What is the clinical evidence from this study?

Study design: Case-Control. Population: Acute heart failure (n=117). Intervention: NYHA functional class IV vs. NYHA functional class I-III. Primary outcome: 7-day mortality (RR 31.429, 95% CI 6.537-151.108, p=<0.001).

December 31, 2024Health Leadership and Quality of Life0 citationsOpen Access

New risk factors predictive of mortality from acute heart failure

Q: What are the key findings of this study?

NYHA functional class IV was the strongest predictor of 7-day mortality (RR 31.429) in patients admitted with acute heart failure, alongside cardiogenic shock and S3/S4 gallop.

LMLucía Nivia Turro Mesa GMGraciela Jiménez Mesa ECEloy Turro Caró

Key Result

NYHA functional class IV was the strongest predictor of 7-day mortality (RR 31.429) in patients admitted with acute heart failure, alongside cardiogenic shock and S3/S4 gallop.

Study Design

Type

Case-Control (n=117)

Multicenter

Structured PICO

Population

117 patients (mean age 70 years, 37.2% female) admitted to the emergency department with acute heart failure, followed for 7 days to identify prognostic factors for mortality.

Outcome

Mortality at 7 days follow-uphard clinical

Clinical factors such as NYHA class IV, cardiogenic shock, gallop rhythm, and malignant arrhythmias are strong predictors of short-term mortality in patients with acute heart failure.

Main Result

Relative Risk: 31.429 (95% CI 6.537–151.108)

p-value: p=<0.001

Limitations

Newer biomarkers for mortality risk prediction were not included due to lack of availability in low-income countries.
Lack of inclusion of new markers not available in low-income countries to improve mortality risk prediction

Abstract

Introduction: Heart failure is a potentially fatal entity. Possible predictors of mortality from heart failure have been explored to improve prognosis.Objective: Identify the prognostic factors of mortality due to acute heart failureMethod: A case-control study nested in a cohort of patients with acute heart failure admitted to the emergency room of the “Saturnino Lora” Provincial Clinical-Surgical Hospital in Santiago de Cuba, from September 2020 to September 2021. The condition of the heart was established as a dependent variable patient and as independent the hypothetical clinical, hematological and echocardiographic prognostic factors. The relative risk (RR), the confidence interval (CI) and the chi-square test were determined to identify the prognostic factors that were associated with mortality. Results: Galloping through S3 or S4 RR 5.636; (1.835-17.309); p=0.001, New York Heart Association (NYHA) functional class IV RR 31.429; (6.537-151.108);p<0.001, supplemental oxygen RR 7.327;(2.689-19.968);p<0.001, cardiogenic shock RR 16.000;(3.346-76.516);p<0.001,malignant ventricular arrhythmia (tachycardia ventricular- ventricular fibrillation) RR 2.250 ;( 1.562-3.242);p<0.001 showed a very significant statistical association with mortality.Conclusions: The presence of gallop and malignant arrhythmias, cardiogenic shock, the need for supplemental oxygen and functional class are adequate predictors of mortality due to acute heart failure, useful to stratify patients and improve prognosis.

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