Regional differences in precipitating factors of hospitalization for acute heart failure: insights from the REPORT‐HF registry

Tromp, J. et al. (2022) Regional differences in precipitating factors of hospitalization for acute heart failure: insights from the REPORT‐HF registry. European Journal of Heart Failure, 24(4), pp. 645-652. (doi: 10.1002/ejhf.2431) (PMID:35064730)

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Abstract

Background: Few prior studies have investigated differences in precipitants leading to hospitalisations for acute heart failure (AHF) in a cohort with global representation. Methods: We analysed the prevalence of precipitants and their association with outcomes in 18,553 patients hospitalised for AHF in REPORT-HF (prospective international REgistry to assess medical Practice with lOngitudinal obseRvation for Treatment of Heart Failure) according to left ventricular ejection fraction (LVEF) subtype (reduced [HFrEF] and preserved ejection fraction [HFpEF]) and presentation (new-onset vs. decompensated chronic HF [DCHF]). Patients were enrolled from 358 centres in 44 countries stratified according to Latin America, North America, western Europe, Eastern Europe, Eastern Mediterranean and Africa, Southeast Asia, and Western Pacific. Precipitants were pre-defined as mutually exclusive categories and selected according to the local investigators discretion. Outcomes included in-hospital and 1-year mortality. Results: The median age was 67 (IQR 57-77) years, and 39% were women. Acute coronary syndrome (ACS) was the most common precipitant in patients with new-onset HF in all regions except for North America and Western Europe, where uncontrolled hypertension and arrhythmia were the most common precipitants, independent of HF subtype and other confounders. In patients with DCHF, non-adherence to diet/medication was the most common precipitant regardless of region. Uncontrolled hypertension was a more likely precipitant in HFpEF, non-adherence to diet/medication, and ACS were more likely precipitants in HFrEF. Patients admitted due to worsening renal function had the worst in-hospital (4%) and 1-year post-discharge (30%) mortality rates, regardless of region, HF subtype and admission type (Pinteraction >0.05 for all). Conclusion: Data on global differences in precipitants for AHF highlight potential regional differences in targets for preventing hospitalisation for AHF and identifying those at highest risk for early mortality.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Cleland, Professor John
Authors: Tromp, J., Beusekamp, J. C., Ouwerkerk, W., Meer, P., Cleland, J. G.F., Angermann, C. E., Dahlstrom, U., Ertl, G., Hassanein, M., Perrone, S. V., Ghadanfar, M., Schweizer, A., Obergfell, A., Filippatos, G., Dickstein, K., Collins, S. P., and Lam, C. S.P.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
Journal Name:European Journal of Heart Failure
Publisher:Wiley
ISSN:1388-9842
ISSN (Online):1879-0844
Published Online:22 January 2022
Copyright Holders:Copyright © 2022 European Society of Cardiology
First Published:First published in European Journal of Heart Failure 24(4): 645-652
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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