Hospitalization and Mortality in Heart Failure

Risk Factors for Recurrent Heart Failure Events in the Multicenter Automatic Defibrillator Trial II (MADIT-II)

Researchers: Sze E, Moss A, McNitt S, et al.

Purpose: To identify among the MADIT-II population risk factors for recurrent heart failure (HF) events, as current data on these risk factors are mostly limited to first event occurrences.

Results: Increased BUN-to-creatinine ratio is a major predictor of recurrent HF events among identified HF risk factors. Sze and colleagues feel their findings should “direct more focus to the prevention of HF progression among patients with evidence of pre-renal azotemia.”

Atrial Fibrillation in Heart Failure Is associated with an Increased Risk of Death Only in Patients with Ischemic Heart Disease

Researchers: Raunso J, Pedersen O, Dominguez H, et al.

Purpose: To “demonstrate that the prognostic impact of atrial fibrillation [AF] in a large heart failure [HF] population depends on an underlying ischemic etiology,” as the “prognostic importance of atrial fibrillation in heart failure (HF) populations is controversial and may depend on patient selection and the etiology of HF.”

Results: Among patients with heart failure, only those with underlying ischemic heart disease will experience an increased risk of death associated with atrial fibrillation.

Factors that Precipitate Hospitalizations for Heart Failure with Preserved Ejection Fraction - Characteristics and Impact on Post-Discharge Outcome

Researchers: Rusinaru D, Buiciuc O, Lévy F, et al.

Purpose: To “investigate the characteristics and impact on long-term outcome of [heart failure (HF)] precipitating factors in patients with heart failure with preserved ejection fraction (HFPEF)],” as hospitalizations “for heart failure are associated with significant mortality and affect post-discharge survival,” several “potentially preventable factors may precipitate HF hospitalizations,” and those factors “that precipitate hospitalizations for heart failure with preserved ejection fraction” have not been studied.

Results: Factors that precipitate hospitalizations are frequent among patients with HFPEF (arrhythmia, 37%; pneumonia, 16%; acute coronary syndromes, 12%; worsening of renal failure, 12%; uncontrolled hypertension, 9%; and non-adherence to therapy, 10%) and predict increased long-term mortality. Survival benefits may be achieved with more attentive management of these factors.

Serial Studies of Seattle Heart Failure Model Improve the Prediction of Pump Failure Death, Not Sudden Death, in Stable Outpatients with Mild to Moderate Chronic Heart Failure: A 10-Year Prospective Study

Researchers: Yamada T, Okuyama Y, Morita T, et al.

Purpose: To “learn the prognostic significance of serial evaluation of Seattle Heart Failure Model [SHFM],” because it remains unclear whether serial studies of SHFM would improve the prediction of the long-term clinical outcome, relating to the mode of death.”

Results: Serial studies of SHFM score could improve the prediction of pump failure death but not sudden cardiac death in patients with mild-to-moderate chronic heart failure.

There were several very good studies presented during this poster session at the 59^th Annual Scientific Sessions of the American College of Cardiology. Here, the best are highlighted.