Cargando…
Clinical presentation at first heart failure hospitalization does not predict recurrent heart failure admission
AIMS: There are limited data on whether clinical presentation at first heart failure (HF) hospitalization predicts recurrent HF events. We aimed to assess predictors of recurrent HF hospitalizations in mild HF patients with an implantable cardioverter defibrillator or cardiac resynchronization thera...
Autores principales: | , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2017
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5695168/ https://www.ncbi.nlm.nih.gov/pubmed/28960867 http://dx.doi.org/10.1002/ehf2.12157 |
_version_ | 1783280264462467072 |
---|---|
author | Kosztin, Annamaria Costa, Jason Moss, Arthur J. Biton, Yitschak Nagy, Vivien Klaudia Solomon, Scott D. Geller, Laszlo McNitt, Scott Polonsky, Bronislava Merkely, Bela Kutyifa, Valentina |
author_facet | Kosztin, Annamaria Costa, Jason Moss, Arthur J. Biton, Yitschak Nagy, Vivien Klaudia Solomon, Scott D. Geller, Laszlo McNitt, Scott Polonsky, Bronislava Merkely, Bela Kutyifa, Valentina |
author_sort | Kosztin, Annamaria |
collection | PubMed |
description | AIMS: There are limited data on whether clinical presentation at first heart failure (HF) hospitalization predicts recurrent HF events. We aimed to assess predictors of recurrent HF hospitalizations in mild HF patients with an implantable cardioverter defibrillator or cardiac resynchronization therapy with defibrillator. METHODS AND RESULTS: Data on HF hospitalizations were prospectively collected for patients enrolled in MADIT‐CRT. Predictors of recurrent HF hospitalization (HF2) after the first HF hospitalization were assessed using Cox proportional hazards regression models including baseline covariates and clinical presentation or management at first HF hospitalization. There were 193 patients with first HF hospitalization, and 156 patients with recurrent HF events. Recurrent HF rate after the first HF hospitalization was 43% at 1 year, 52% at 2 years, and 55% at 2.5 years. Clinical signs and symptoms, medical treatment, or clinical management of HF at first HF admission was not predictive for HF2. Baseline covariates predicting recurrent HF hospitalization included prior HF hospitalization (HR = 1.59, 95% CI: 1.15–2.20, P = 0.005), digitalis therapy (HR = 1.58, 95% CI: 1.13–2.20, P = 0.008), and left ventricular end‐diastolic volume >240 mL (HR = 1.62, 95% CI: 1.17–2.25, P = 0.004). CONCLUSIONS: Recurrent HF events are frequent following the first HF hospitalization in patients with implanted implantable cardioverter defibrillator or cardiac resynchronization therapy with defibrillator. Neither clinical presentation nor clinical management during first HF admission was predictive of recurrent HF. Prior HF hospitalization, digitalis therapy, and left ventricular end‐diastolic volume at enrolment predicted recurrent HF hospitalization, and these covariates could be used as surrogate markers for identifying a high‐risk cohort. |
format | Online Article Text |
id | pubmed-5695168 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-56951682018-02-14 Clinical presentation at first heart failure hospitalization does not predict recurrent heart failure admission Kosztin, Annamaria Costa, Jason Moss, Arthur J. Biton, Yitschak Nagy, Vivien Klaudia Solomon, Scott D. Geller, Laszlo McNitt, Scott Polonsky, Bronislava Merkely, Bela Kutyifa, Valentina ESC Heart Fail Original Research Articles AIMS: There are limited data on whether clinical presentation at first heart failure (HF) hospitalization predicts recurrent HF events. We aimed to assess predictors of recurrent HF hospitalizations in mild HF patients with an implantable cardioverter defibrillator or cardiac resynchronization therapy with defibrillator. METHODS AND RESULTS: Data on HF hospitalizations were prospectively collected for patients enrolled in MADIT‐CRT. Predictors of recurrent HF hospitalization (HF2) after the first HF hospitalization were assessed using Cox proportional hazards regression models including baseline covariates and clinical presentation or management at first HF hospitalization. There were 193 patients with first HF hospitalization, and 156 patients with recurrent HF events. Recurrent HF rate after the first HF hospitalization was 43% at 1 year, 52% at 2 years, and 55% at 2.5 years. Clinical signs and symptoms, medical treatment, or clinical management of HF at first HF admission was not predictive for HF2. Baseline covariates predicting recurrent HF hospitalization included prior HF hospitalization (HR = 1.59, 95% CI: 1.15–2.20, P = 0.005), digitalis therapy (HR = 1.58, 95% CI: 1.13–2.20, P = 0.008), and left ventricular end‐diastolic volume >240 mL (HR = 1.62, 95% CI: 1.17–2.25, P = 0.004). CONCLUSIONS: Recurrent HF events are frequent following the first HF hospitalization in patients with implanted implantable cardioverter defibrillator or cardiac resynchronization therapy with defibrillator. Neither clinical presentation nor clinical management during first HF admission was predictive of recurrent HF. Prior HF hospitalization, digitalis therapy, and left ventricular end‐diastolic volume at enrolment predicted recurrent HF hospitalization, and these covariates could be used as surrogate markers for identifying a high‐risk cohort. John Wiley and Sons Inc. 2017-06-17 /pmc/articles/PMC5695168/ /pubmed/28960867 http://dx.doi.org/10.1002/ehf2.12157 Text en © 2017 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Research Articles Kosztin, Annamaria Costa, Jason Moss, Arthur J. Biton, Yitschak Nagy, Vivien Klaudia Solomon, Scott D. Geller, Laszlo McNitt, Scott Polonsky, Bronislava Merkely, Bela Kutyifa, Valentina Clinical presentation at first heart failure hospitalization does not predict recurrent heart failure admission |
title | Clinical presentation at first heart failure hospitalization does not predict recurrent heart failure admission |
title_full | Clinical presentation at first heart failure hospitalization does not predict recurrent heart failure admission |
title_fullStr | Clinical presentation at first heart failure hospitalization does not predict recurrent heart failure admission |
title_full_unstemmed | Clinical presentation at first heart failure hospitalization does not predict recurrent heart failure admission |
title_short | Clinical presentation at first heart failure hospitalization does not predict recurrent heart failure admission |
title_sort | clinical presentation at first heart failure hospitalization does not predict recurrent heart failure admission |
topic | Original Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5695168/ https://www.ncbi.nlm.nih.gov/pubmed/28960867 http://dx.doi.org/10.1002/ehf2.12157 |
work_keys_str_mv | AT kosztinannamaria clinicalpresentationatfirstheartfailurehospitalizationdoesnotpredictrecurrentheartfailureadmission AT costajason clinicalpresentationatfirstheartfailurehospitalizationdoesnotpredictrecurrentheartfailureadmission AT mossarthurj clinicalpresentationatfirstheartfailurehospitalizationdoesnotpredictrecurrentheartfailureadmission AT bitonyitschak clinicalpresentationatfirstheartfailurehospitalizationdoesnotpredictrecurrentheartfailureadmission AT nagyvivienklaudia clinicalpresentationatfirstheartfailurehospitalizationdoesnotpredictrecurrentheartfailureadmission AT solomonscottd clinicalpresentationatfirstheartfailurehospitalizationdoesnotpredictrecurrentheartfailureadmission AT gellerlaszlo clinicalpresentationatfirstheartfailurehospitalizationdoesnotpredictrecurrentheartfailureadmission AT mcnittscott clinicalpresentationatfirstheartfailurehospitalizationdoesnotpredictrecurrentheartfailureadmission AT polonskybronislava clinicalpresentationatfirstheartfailurehospitalizationdoesnotpredictrecurrentheartfailureadmission AT merkelybela clinicalpresentationatfirstheartfailurehospitalizationdoesnotpredictrecurrentheartfailureadmission AT kutyifavalentina clinicalpresentationatfirstheartfailurehospitalizationdoesnotpredictrecurrentheartfailureadmission |