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[Cardiovascular death in patients with acute heart failure in sinus rhythm: results from the RICA registry]
Alberto Elpidio Calvo-Elías1, Manuel Méndez-Bailón2, Francisco Javier Martín-Sánchez3
1Medicina Interna, Hospital General Universitario Gregorio Marañón, Madrid, España.
Insights
Heart failure patients in sinus rhythm with reduced left ventricular ejection fraction (LVEF) face higher cardiovascular death risk. Worse scores on Barthel and Charlson indices also predict mortality.
Area of Science:
- Cardiology
- Clinical Research
Background:
- Patients with heart failure in sinus rhythm are at significant risk of cardiovascular events, including death.
- Left ventricular ejection fraction (LVEF) is a key indicator in heart failure prognosis.
Purpose of the Study:
- To evaluate one-year cardiovascular (CV) mortality in heart failure patients with sinus rhythm.
- To analyze CV mortality across different left ventricular ejection fraction (LVEF) subgroups.
Main Methods:
- Prospective, multicenter study using the National Registry of Heart Failure data.
- Demographic, clinical, and treatment analyses were performed comparing CV death.
- Multivariate logistic regression and Kaplan-Meier survival analyses were conducted, incorporating LVEF.
Main Results:
- 14.8% of 2040 included patients experienced CV death.
- Predictors of mortality included a lower Barthel index (OR 0.987), LVEF <40% (OR 1.514), and higher Charlson index (OR 1.069).
Conclusions:
- CV death is significantly higher in heart failure patients with reduced LVEF, in sinus rhythm.
- Poorer scores on the Barthel and Charlson indices are associated with increased CV mortality in this population.
Introduction:
Patients with heart failure in sinus rhythm may be at significant risk of major cardiovascular events, including cardiovascular death (CV death).
Objective:
To assess CV mortality at a one-year follow up of those patients with heart failure and sinus rhythm, according to LVEF subgroups.
Methods:
A prospective and multicentric study was conducted with patients in sinus rhythm included in the National Registry of Heart Failure. Firstly, a demographic, clinical and treatment analysis has been made comparing CV death. Secondly, a multivariate analysis of logistic regression was made including those CV death factors. Lastly, a Kaplan Meyer one year survival was made including LVEF.
Results:
Of all 2040 patients included 14,8% presented CV death. The mortality predictors were Barthel index (OR 0,987 (0,982-0,992) [p<0,001]), LVEF <40% (OR 1,514 (1,144-2,003) [p 0,003]) and Charlson index (OR 1,069 (1,016-1,124) [p 0,01]).
Conclusion:
According to our results CV death has been shown to be higher in those patients with reduced LVEF in sinus rhythm and worst score in Barthel index and Charlson scale.
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