Biomedical papers, 2016 (vol. 160), issue 2

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2016, 160(2):257-262 | 10.5507/bp.2015.049

Ten-year survival and prognostic markers in one thousand patients with advanced heart failure. A single-centre analysis

Peter Lesnya, Milan Luknara, Martin Matejkab, Ivan Vargaa, Peter Solika, Sona Wimmerovac, Eva Goncalvesovaa
a Heart Failure and Transplant Department, National Cardiovascular Institute, Bratislava, Slovak Republic
b Adolescent Clinic, Dunajska Luzna, Slovak Republic
c Slovak Medical University, Bratislava, Slovak Republic

Aim: Patients with advanced heart failure (HF) represent a pool of candidates for heart transplantation and long-term mechanical circulatory support devices. The aim of our study was to determine simple and reliable markers of one-year mortality for selection of the most suitable patients for heart replacement therapy.

Methods and Results: One thousand consecutive patients with HF (mean age 49 ± 10.9 years; 86.8% males) referred to a single tertiary centre from January 1998 to January 2010 in order to assess the indication for heart transplantation were enrolled. Kaplan-Meier survival analysis was performed. Independent mortality predictors were established using logistic regression analysis. The mean follow-up was 4.3 ± 2.7 years (range 1-12 years). Cumulative survival was as follows: 1-year survival 83%, 3-year 63%, 5-year 50%, 7-year 39%, and 10-year 23%. Independent predictors of 1-year mortality included coronary artery disease, left ventricular diastolic diameter >79 mm, plasma sodium <135 mmol/L, the need for intravenous treatment at hospital admission (diuretics and/or inotropes), and furosemide dose at discharge >240 mg/day.

Conclusions: Short-term prognosis of HF patient can be estimated based on simple parameters. Patients with signs of poor prognosis should be referred to tertiary centres to be considered for heart replacement therapy.

Keywords: heart failure, survival prognosis, heart transplantation, mechanical circulatory support

Received: June 10, 2015; Accepted: September 17, 2015; Prepublished online: October 23, 2015; Published: June 24, 2016


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