Comprehensive Analysis of Heart Failure Subtypes Presenting at Emergency Department for Acute Heart Failure...

Area of Science:

• Cardiology
• Emergency Medicine
• Biomarkers

Background:

• Pathophysiological complexities across heart failure categories (reduced, midrange, preserved ejection fraction) remain incompletely understood despite advances in diagnostics.
• This study focuses on characterizing patients presenting with acute heart failure to the emergency department across these three subtypes.

Purpose of the Study:

• To analyze and compare the distinct clinical characteristics, echocardiographic measures, and biomarker profiles of patients across different heart failure subtypes.
• To identify potential differences that can inform risk stratification and tailored interventions in the emergency department setting.

Main Methods:

• Retrospective analysis of 954 acute heart failure patients (2016-2023) utilizing electronic health records.
• Data collection included triage, emergency department, and hospitalization information.
• Kaplan-Meier survival analysis and an elastic net model were employed for statistical analysis.

Main Results:

• Patients with heart failure with preserved ejection fraction were older (median 80 years) compared to other subtypes.
• Heart failure with reduced ejection fraction patients exhibited higher prevalence of cardiomegaly, pleural effusion, orthopnea, and elevated NT-proBNP.
• Prediction models demonstrated strong performance: 0.84 AUC in-hospital and 0.80 AUC for 30-day predictions.

Conclusions:

• Distinct clinical and biomarker profiles exist among heart failure subtypes.
• Emergency nurses' recognition of these differences can enhance risk stratification and guide tailored interventions, improving patient outcomes.
• Integrating subtype-specific data into emergency department protocols can optimize care, especially during prolonged patient boarding.