Predictors of mortality and hospitalization for cardiac causes in patients with heart failure and nonischemic heart disease: A subanalysis of the ALPHA study

Matteo Anselmino, Gaetano M. De Ferrari, Riccardo Massa, Lorenzo Manca, Massimo Tritto, Giulio Molon, Antonio Curnis, Paolo Devecchi, Simona Sarzi Braga, Giorgio Bartesaghi, Catherine Klersy, Francesco Accardi, Jorge A. Salerno-Uriarte

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Background: Several studies have searched for predictors of clinical outcome in patients with heart failure (HF). However, since they were collected in clinical trials, most data were subject to selection biases and do not specifically apply to patients with nonischemic heart disease. This study examined the impact of several variables on combined all-cause mortality and hospitalization for cardiac causes, in consecutive ambulatory patients with HF included in the ALPHA registry. Methods and Results: This analysis included 446 patients with HF and nonischemic heart disease, in New York Heart Association functional class II or III, and a left ventricular (LV) ejection fraction below 40%. In 126 patients (73%) the disease was idiopathic dilated cardiomyopathy, in 72 (16%) hypertensive, in nine (2%) valvular, and in 39 (9%) of other etiologies. The median age was 61 years (range 51-69 years) and 349 (78%) patients were men. Over a median follow-up of 31 months (range 23-40), 82 patients (18%) died or were hospitalized for cardiac causes. In a proportional hazard (Cox) regression model, maximal oxygen consumption (HR 0.9, P = 0.001), LV end-diastolic diameter (HR 1.07, P <0.001), resting systolic blood pressure (HR 0.97, P <0.005), and hemoglobin (HR 0.86, P <0.05) were independent predictors of the combined study endpoint. Conclusions: In an unselected population of patients with HF and nonischemic heart disease, a reduced exercise capacity, large LV end-diastolic diameter, low systolic blood pressure, and hemoglobin were correlated with long-term all-cause mortality or hospitalization for cardiac causes. These observations may help stratifying and tailoring the treatment of patients with HF and nonischemic heart disease.

Original languageEnglish
JournalPACE - Pacing and Clinical Electrophysiology
Issue numberSUPPL. 1
Publication statusPublished - Mar 2009



  • Dilated cardiomyopathy
  • Heart failure
  • Nonischemic heart disease
  • Predictor analysis
  • Survival analysis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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