Acute decompensated heart failure with preserved systolic function was associated with lower in-hospital mortality compared to systolic dysfunction (2.8% vs. 3.9%; adjusted OR 0.86; p=0.005).
Observational (n=100,000)
Yes
What are the clinical characteristics and in-hospital outcomes of patients admitted with acute decompensated heart failure with preserved systolic function compared to those with systolic dysfunction?
Patients hospitalized with acute decompensated heart failure with preserved systolic function represent half of HF admissions and have slightly lower in-hospital mortality but similar lengths of stay compared to those with systolic dysfunction.
Odds Ratio: 0.86
Absolute Event Rate: 2.8% vs 3.9%
p-value: p=0.005
UNLABELLED Approximately 50% of patients hospitalized for heart failure have preserved systolic function. These patients are more likely to be older, women, and hypertensive. Their duration of hospitalization is similar to that of heart failure patients with systolic dysfunction, but their in-hospital mortality risk is lower. This mortality risk is increased in the setting of renal insufficiency, and the two most important risk predictors are elevated blood urea nitrogen and systolic blood pressure 100,000 hospitalizations from the Acute Decompensated Heart Failure National Registry (ADHERE) database were analyzed. RESULTS Heart failure with PSF was present in 50.4% of patients with in-hospital assessment of left ventricular function. When compared with patients with systolic dysfunction, patients with PSF were more likely to be older, women, and hypertensive and less likely to have had a prior myocardial infarction or be receiving an angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker. In-hospital mortality was lower in patients with PSF compared with patients with systolic dysfunction (2.8% vs. 3.9%; adjusted odds ratio OR: 0.86; p = 0.005), but duration of intensive care unit stay and total hospital length of stay were similar. Serum creatinine >2 mg/dl was associated with increased in-hospital mortality in both systolic function groups (PSF: 4.8%; systolic dysfunction: 8.4%; p 37 mg/dl (OR: 2.53; 95% confidence interval CI: 2.22 to 2.87) and systolic blood pressure < or =125 mm Hg (OR: 2.58; 95% CI: 2.33 to 2.86). CONCLUSIONS Heart failure with PSF is common and is characterized by a unique patient profile. Event rates are worrisome and reflect a need for more effective management strategies.
Yancy et al. (2005) conducted an observational in Acute decompensated heart failure (n=100,000). Preserved systolic function vs. Systolic dysfunction was evaluated on In-hospital mortality (OR 0.86, p=0.005). Acute decompensated heart failure with preserved systolic function was associated with lower in-hospital mortality compared to systolic dysfunction (2.8% vs. 3.9%; adjusted OR 0.86; p=0.005).