CBS 2019
CBSMD教育中心
中 文

Congestive Heart Failure

Abstract

Recommended Article

Criteria for Iron Deficiency in Patients With Heart Failure Association of the Hospital Readmissions Reduction Program With Mortality Among Medicare Beneficiaries Hospitalized for Heart Failure, Acute Myocardial Infarction, and Pneumonia Effects of Dapagliflozin on Symptoms, Function and Quality of Life in Patients with Heart Failure and Reduced Ejection Fraction: Results from the DAPA-HF Trial Association Between Functional Impairment and Medication Burden in Adults with Heart Failure Effect of Luseogliflozin on Heart Failure With Preserved Ejection Fraction in Patients With Diabetes Mellitus Circulating sST2 and catestatin levels in patients with acute worsening of heart failure: a report from the CATSTAT-HF study When and how to use SGLT2 inhibitors in patients with HFrEF or chronic kidney disease H2FPEF Score for Predicting Future Heart Failure in Stable Outpatients With Cardiovascular Risk Factors

Review Article19 December 2020

JOURNAL:https://onlinelibrary.wiley.com/doi/epdf/10.1002/e Article Link

Is Acute heart failure a distinctive disorder? An analysis from BIOSTAT-CHF

BA Davison, S Senger, IE Sama et al. Keywords: acute heart failure; HF outpatients; diagnosis; treatment;

ABSTRACT

AIMS -This retrospective analysis sought to identify markers that might distinguish between acute heart failure (HF) and worsening HF in chronic outpatients.


METHODS AND RESULTS -The BIOSTAT‐CHF index cohort included 2516 patients with new or worsening HF symptoms: 1694 enrolled as inpatients (acute HF) and 822 as outpatients (worsening HF in chronic outpatients). A validation cohort included 935 inpatients and 803 outpatients. Multivariable models were developed in the index cohort using clinical characteristics, routine laboratory values, and proteomics data to examine which factors predict adverse outcomes in both conditions and to determine which factors differ between acute HF and worsening HF in chronic outpatients, validated in the validation cohort.

Patients with acute HF had substantially higher morbidity and mortality (6 months mortality was 12..3% for acute HF and 4..7% for worsening HF in chronic outpatients). Multivariable models predicting 180‐day mortality and 180‐day HF re‐admission differed substantially between acute HF and worsening HF in chronic outpatients. CA‐125 was the strongest single biomarker to distinguish acute HF from worsening HF in chronic outpatients, but only yielded a C‐index of 0..71. A model including multiple biomarkers and clinical variables achieved a high degree of discrimination with a C‐index of 0..913 in the index cohort and 0..901 in the validation cohort.


CONCLUSION - The study identifies different characteristics and predictors of outcome in acute HF patients as compared to outpatients with chronic HF developing worsening HF. The markers identified may be useful in better diagnosing acute HF and may become targets for treatment development.