CBS 2019
CBSMD教育中心
中 文

Congestive Heart Failure

Abstract

Recommended Article

Clinical epidemiology of heart failure with preserved ejection fraction (HFpEF) in comparatively young hospitalized patients Noninvasive Imaging for the Evaluation of Diastolic Function: Promises Fulfilled Angiotensin–Neprilysin Inhibition in Heart Failure with Preserved Ejection Fraction A population-based study of 92 clinically recognised risk factors for heart failure: co-occurrence, prognosis and preventive potential Sex- and Race-Related Differences in Characteristics and Outcomes of Hospitalizations for Heart Failure With Preserved Ejection Fraction Natriuretic Peptide-Guided Heart Failure Therapy After the GUIDE-IT Study The spectrum of heart failure: value of left ventricular ejection fraction and its moving trajectories Longitudinal Change in Galectin-3 and Incident Cardiovascular Outcomes

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.