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Long-Term Prognosis of Patients with Heart Failure: Follow-Up Results of Journey HF-TR Study Population
Cengiz Şabanoğlu1, Ümit Yaşar Sinan2, Mehmet Kadri Akboğa3
1Department of Cardiology, Kırıkkale Yüksek İhtisas Hospital, Kırıkkale, Türkiye.
Insights
Despite treatment advances, heart failure patients face high 3-year mortality and hospitalization rates. Key medications and cardiac device implantation reduced mortality, but more efforts are needed to improve survival.
Area of Science:
- Cardiology
- Clinical Research
- Public Health
Background:
- Heart failure (HF) continues to exhibit increasing global morbidity and mortality despite therapeutic advancements.
- The Journey HF-TR study initially evaluated acute heart failure patients in 2016.
- This study presents 3-year follow-up outcomes using national registry data.
Purpose of the Study:
- To report the 3-year follow-up outcomes of patients from the Journey HF-TR study.
- To analyze clinical characteristics and management strategies in acute heart failure.
- To identify factors influencing mortality and hospitalization in heart failure patients.
Main Methods:
- Retrospective analysis of patient data from November 2016 to December 2019.
- Included 1311 patients after excluding those with in-hospital death or incomplete data from the initial 1606.
- Cox regression analysis adjusted for age, gender, comorbidities, precipitating factors, NYHA class, and LVEF.
Main Results:
- The 3-year follow-up revealed a 70.5% hospitalization rate and a 52.1% mortality rate.
- Leading causes of death included acute decompensated heart failure and acute coronary syndrome.
- Mortality was reduced by angiotensin receptor blockers, betablockers, statins, and sacubitril/valsartan; cardiac device implantation also improved survival.
Conclusions:
- Long-term mortality in heart failure patients remains high, necessitating further research and improved management strategies.
- Hospitalization for acute decompensated heart failure, acute coronary syndrome, and other comorbidities significantly increases mortality risk.
- Enhanced therapeutic interventions and management are crucial for improving both in-hospital and long-term survival in chronic heart failure.
Background:
Despite advances in therapeutic management of patients with heart failure, there is still an increasing morbidity and mortality all over the world. In this study, we aimed to present the 3-year follow-up outcomes of patients included in the Journey HF-TR study in 2016 that has evaluated the clinical characteristics and management of patients with acute heart failure admitted to the hospital and present a national registry data.
Methods:
The study was designed retrospectively between November 2016 and December 2019. Patient data included in the previously published Journey HF-TR study were used. Among 1606 patients, 1484 patients were included due to dropout of 122 patients due to inhospital death and due to exclusion of 173 due to incomplete data. The study included 1311 patients. Age, gender, concomitant chronic conditions, precipitating factors, New York Heart Association, and left ventricular ejection fraction factors were adjusted in the Cox regression analysis.
Results:
During the 3-year follow-up period, the ratio of hospitalization and mortality was 70.5% and 52.1%, respectively. Common causes of mortality were acute decompensation of heart failure and acute coronary syndrome. Angiotensin receptor blockers, betablockers, statin, and sacubitril/valsartan were found to reduce mortality. Hospitalization due to acute decompensated heart failure, acute coronary syndrome, lung diseases, oncological diseases, and cerebrovascular diseases was associated with the increased risk of mortality. Implantation of cardiac devices also reduced the mortality.
Conclusions:
Despite advances in therapeutic management of patients with heart failure, our study demonstrated that the long-term mortality still is high. Much more efforts are needed to improve the inhospital and long-term survival of patients with chronic heart failure.
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