Meeting abstract

https://doi.org/10.15836/ccar2019.221

Survival of heart failure patients with reduced and preserved ejection fraction is not different!

Azra Durak- Nalbantić orcid.org/0000-0002-5175-8941 ; Clinical Center of the University of Sarajevo, Sarajevo, Bosnia and Herzegovina
Alen Džubur ; Clinical Center of the University of Sarajevo, Sarajevo, Bosnia and Herzegovina
Nafija Serdarević orcid.org/0000-0001-7977-9819 ; Clinical Center of the University of Sarajevo, Sarajevo, Bosnia and Herzegovina
Aida Hamzić- Mehmedbašić ; Clinical Center of the University of Sarajevo, Sarajevo, Bosnia and Herzegovina
Faris Zvizdić ; Clinical Center of the University of Sarajevo, Sarajevo, Bosnia and Herzegovina
Enisa Hodžić ; Clinical Center of the University of Sarajevo, Sarajevo, Bosnia and Herzegovina
Marina Vučijak- Grgurević ; Clinical Center of the University of Sarajevo, Sarajevo, Bosnia and Herzegovina
Alden Begić ; Clinical Center of the University of Sarajevo, Sarajevo, Bosnia and Herzegovina
Akif Mlaćo ; Clinical Center of the University of Sarajevo, Sarajevo, Bosnia and Herzegovina
Zenisa Gljiva-Gogić ; Clinical Center of the University of Sarajevo, Sarajevo, Bosnia and Herzegovina

Abstract

Introduction: A progress in the management of cardiovascular disease leads to a decrease in mortality,
but heart failure (HF) seems to be an exception. Today, the rate of rehospitalization and mortality after
acute heart failure is still very high. Lower ejection fraction (EF) means worse prognosis, but recent
studies are reporting that HF patients with preserved EF have no better survival compared to patients
with reduced EF1. Goal: to investigate a possible difference in the outcome of HF patients with reduced
(HFREF) and preserved ejection fraction (HFPEF).
Patients and Methods: In 222 patients hospitalized in acute HF (138 with reduced EF and 74 with preserved
EF) were determined routine laboratory test, including BNP. The LVEF cutoff for diagnosing of
HFPEF was above 45 %. Patients were followed for the next 18 months for the occurrence of 1. readmission
due to repeat decompensation and 2. mortality.
Results: BNP at discharge was
higher in HFREF compared to
HFPEF group [699.3 (271.8-1519.1)
pg/ml vs 263.3 (134.4-502.2) pg/
ml, p <0.001]. During 18-month
follow-up 129 patients (58.11%)
were readmitted due to decompensation,
but there was no
significant difference between
group: in HFREF group was hospitalized
87 (63.04%) patients
compared to 42 (50%) patients
in HFPEF group (p=0.077). There
was no difference in the rate of
readmission in 1-month (p=0.7),
6-month (p=0.24), and 12-month
follow up (p=0.16) in HFREF vs
HFPEF group. In Kaplan-Meier
curve there was no significant
difference in the mean time
of the occurrence of readmission
due to decompensation: in
HFREF group 2.2 (95% CI=1.58-
2.8) months and in HFPEF group
2.33 (95% CI=1.3-3.4) months (p=0.89) (Figure 1). In HFREF 18-month survival was 43.5% (60/138) and in
HFPEF group was 56.0 % (47/84) and the difference was not significant (p=0,096). In the Kaplan-Meier
curve, there was no difference in time of survival in 18-month follow-up (p=0.9): mean time of survival
in HFREF was 3.8 (95% CI=3.0-4.7) months and in HFPEF 3.75 (95% CI=2.5-5.0) months (Figure 2). There
was no difference in mortality in 1-month (p=0.8), 6-month (p=0.16) and 12-month follow up (p=0.08).
Conclusion: Rate of rehospitalization due to decompensation and mortality is not different between
HFREF and HFPEF group. Preserved EF is not related to better survival in patients with HF.

Keywords

heart failure; mortality

Hrčak ID:

226691

URI

https://hrcak.srce.hr/226691

Publication date:

15.10.2019.

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