Relation of Left Ventricular Ejection Fraction and Clinical Features or Co-morbidities to Outcomes Among Patients Hospitalized for Acute Heart Failure Syndromes - 10/01/15
, Naoki Sato, MD b, Teruo Takano, MD con behalf of the
investigators of the Acute Decompensated Heart Failure Syndromes (ATTEND) registry
Abstract |
The aim of this study was to evaluate the heterogeneity of the association of a preserved or reduced ejection fraction (EF) with the increased risk of outcomes among patients with acute heart failure syndromes. Of the 4,842 patients enrolled in the Acute Decompensated Heart Failure Syndromes (ATTEND) registry in Japan, 4,720 patients were evaluated to investigate the association of EF and clinical features or co-morbidities with all-cause mortality after admission. The median follow-up period after admission was 519 (388 to 781) days. The all-cause mortality rate did not differ between the reduced EF and preserved EF groups (24.9% and 24.5%, respectively). To evaluate the heterogeneity of the influence of a preserved or reduced EF on all-cause mortality, subgroup analyses were performed. As a result, there were significant interactions in the association of a preserved or reduced EF with all-cause mortality when the patients were stratified by an ischemic cause, a hypertensive cause, previous hospitalization for heart failure, diabetes mellitus, and anemia. The influence of a nonischemic cause, a hypertensive cause, or new-onset heart failure on the risk of all-cause mortality was significantly greater in patients with preserved EF than in those with reduced EF. In contrast, the influence of diabetes mellitus or anemia on the risk of all-cause mortality was significantly greater in patients with reduced EF than in those with preserved EF. In conclusion, the present analysis demonstrated that the association of a preserved or reduced EF with the clinical outcome differs markedly in relation to the clinical features or co-morbidities of these patients.
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| This work was supported by the Japan Heart Foundation (Tokyo, Japan), which had no role in the conduct of the study, but provided funding for statistical support and administration. Before commencing the ATTEND registry, information on the objectives of this study, its social significance, and an abstract were provided for clinical trial registration with the University Hospital Medical Information Network (UMIN; Clinical Trial Registration ID UMIN000000736). The funding organization did not participate in the design and conduct of this study; in the collection, analysis, and interpretation of data; or in the preparation, review, or approval of the manuscript. |
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| See page 339 for disclosure information. |
Vol 115 - N° 3
P. 334-340 - février 2015 Retour au numéro
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