Acute heart failure:: Clinical presentation, one-year mortality and prognostic factors

Aims: Acute heart failure (T-IF) is a common but ill-defined clinical entity. We describe patients hospitalised with acute HF in regard of clinical presentation, mortality, and risk factors for an unfavourable outcome. Methods and results: We conducted a prospective study including 312 consecutive patients from two European centers hospitalised with acute HF, defined as new onset or worsening of symptoms and signs of HF within 7 days. The mean age was 73 years and 56% were men. Twenty-eight percent had de-novo acute HF and 72% a decompensation of chronic HE Coronary heart disease (CHD) was the most frequent underlying heart disease, elevated blood pressure > 150 mmHg and acute ischemia being the most important triggers. Four percent of the patients bad cardiogenic shock, 13% presented with pulmonary edema. LV-EF was < 35%, 35-50% and > 50% in 35%, 32% and 33% of the patients, respectively. ICU-treatment was necessary in 39% of the patients. Thirty-day mortality (11%) was increased in the presence of shock or elevated troponin T levels. Twelve-month all-cause mortality (29%) increased in the presence of shock, left ventricular dysfunction, renal insufficiency, CHD, and age. Conclusions: This prospective study shows that despite modem treatment, morbidity and mortality of patients hospitalised with acute HF remain high. (c) 2005 European Society of Cardiology. Published by Elsevier B.V All rights reserved.