Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2021, 165(1):34-42 | DOI: 10.5507/bp.2020.038

Differences in risk profiles and long-term outcomes in acute heart failure patients with preserved and reduced left ventricular ejection fraction in the Czech Republic: The AHEAD registry sub-analysis

Roman Miklika,b, Marie Miklikovac,d, Radim Spaceke, Jindrich Spinarc,d, Kamil Zemane, Klara Benesovaf, Marian Felsocic, Lidka Pohludkovae, Ladislav Dusekf, Jiri Jarkovskyf, Petr Lokajc,d, Ilona Parenicovag, Jiri Parenicac,d
a Cardiology, Podlesi Hospital Trinec, Czech Republic
b Internal Department, Military Hospital Brno, Czech Republic
c Department of Cardiology, University Hospital Brno, Czech Republic
d Medical Faculty, Masaryk University, Brno, Czech Republic
e Department of Internal Medicine, Hospital Frydek-Mistek, Frydek-Mistek, Czech Republic
f Institute of Biostatistics and Analysis, Faculty of Medicine, Masaryk University, Brno, Czech Republic
g Centre of Cardiovascular and Transplant Surgery, Pekarska 53, Brno, Czech Republic

Background: The latest European heart failure guidelines define patients as those with reduced (HFrEF), mid-range, and preserved (HFpEF) left ventricular ejection fraction (LVEF; <40%, 40%-49%, and ≥50%, respectively). We investigated the causes of rehospitalizations/deaths in our institution's heart failure patients and focused on differences in the clinical presentation, risk profile, and long-term outcomes between the HFrEF and HFpEF groups in a real-life scenario.

Methods and Results: We followed 1274 patients discharged from heart failure hospitalization in 2 centres. The mean patient age was 75.9 years, and men and women were represented equally. During the minimal follow-up of 2 years, 57% of patients were hospitalised for any cause, 24.9% for decompensated heart failure, and 43.3% for any cardiovascular cause. A total of 36.1% of patients died, either with prior (11.8%) or without prior (24.3%) heart failure rehospitalization. Heart failure was also the most frequent cause of cardiovascular hospitalization, followed by gastrointestinal problems, infections, and tumours for noncardiovascular hospitalizations. Patients with HFrEF had different baseline characteristics and risk profiles, experienced more hospitalizations for acute heart failure (28.6% vs 20.2%, P=0.012), and had higher cardiovascular mortality (82.4% vs 63.5%, P<0.001) when compared with HFpEF patients. Overall mortality and rehospitalization rates were similar.

Conclusion: Within 2 years, half of the patients died and/or were hospitalised for acute decompensation of heart failure, and only one-third of the patients survived without any hospitalization. HFrEF and HFpEF patients were confirmed to be different entities with diverse characteristics, risk profiles, and cardiovascular event rates.

Keywords: acute heart failure, left ventricular ejection fraction, rehospitalization, AHEAD, mortality

Received: June 14, 2020; Revised: August 30, 2020; Accepted: September 4, 2020; Prepublished online: October 1, 2020; Published: March 12, 2021  Show citation

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Miklik, R., Miklikova, M., Spacek, R., Spinar, J., Zeman, K., Benesova, K., ... Parenica, J. (2021). Differences in risk profiles and long-term outcomes in acute heart failure patients with preserved and reduced left ventricular ejection fraction in the Czech Republic: The AHEAD registry sub-analysis. Biomedical papers, 165(1), 34-42. doi: 10.5507/bp.2020.038
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