Prognostic impact of comorbidities in hospitalized patients with acute exacerbation of chronic heart failure

D. Scrutinio, A. Passantino, P. Guida, E. Ammirati, F. Oliva, S.S. Braga, M.T. La Rovere, R. Lagioia, M. Frigerio

Research output: Contribution to journalArticle

Abstract

Background To assess the impact of comorbidities on long-term all-cause mortality in patients hospitalized with exacerbated signs/symptoms of previously chronic stable HF (AE-CHF). Methods 1119 patients admitted for AE-CHF and with NT-proBNP levels > 900 pg/mL were enrolled. Univariable and multivariable Cox analyses were performed to assess the association of age, gender, hypertension, diabetes, obesity, atrial fibrillation, coronary heart disease (CHD), chronic obstructive pulmonary disease, previous cerebrovascular accidents, chronic liver disease (CLD), thyroid disease, renal impairment (RI), and anemia with 3-year all-cause mortality. Results During the follow-up, 441 patients died and 126 underwent heart transplantation (HT) or ventricular assist device (VAD) implantation. 45.8% of the fatal events and 52.4% of HT/VAD implantations occurred within 180 days after admission. Increasing age (p = .012), obesity (p = .037), atrial fibrillation (p = .030), CHD (p = .015), CLD (p = .001), RI (p 
Original languageEnglish
Pages (from-to)63-67
Number of pages5
JournalEuropean Journal of Internal Medicine
Volume34
DOIs
Publication statusPublished - 2016

Fingerprint

Heart-Assist Devices
Comorbidity
Heart Failure
Heart Transplantation
Atrial Fibrillation
Coronary Disease
Liver Diseases
Chronic Disease
Obesity
Kidney
Mortality
Thyroid Diseases
Chronic Obstructive Pulmonary Disease
Signs and Symptoms
Anemia
Stroke
Hypertension

Keywords

  • Acute decompensated heart failure
  • Comorbidity
  • Mortality

Cite this

Prognostic impact of comorbidities in hospitalized patients with acute exacerbation of chronic heart failure. / Scrutinio, D.; Passantino, A.; Guida, P.; Ammirati, E.; Oliva, F.; Braga, S.S.; La Rovere, M.T.; Lagioia, R.; Frigerio, M.

In: European Journal of Internal Medicine, Vol. 34, 2016, p. 63-67.

Research output: Contribution to journalArticle

@article{93f38347db324f1fb4891229698a063a,
title = "Prognostic impact of comorbidities in hospitalized patients with acute exacerbation of chronic heart failure",
abstract = "Background To assess the impact of comorbidities on long-term all-cause mortality in patients hospitalized with exacerbated signs/symptoms of previously chronic stable HF (AE-CHF). Methods 1119 patients admitted for AE-CHF and with NT-proBNP levels > 900 pg/mL were enrolled. Univariable and multivariable Cox analyses were performed to assess the association of age, gender, hypertension, diabetes, obesity, atrial fibrillation, coronary heart disease (CHD), chronic obstructive pulmonary disease, previous cerebrovascular accidents, chronic liver disease (CLD), thyroid disease, renal impairment (RI), and anemia with 3-year all-cause mortality. Results During the follow-up, 441 patients died and 126 underwent heart transplantation (HT) or ventricular assist device (VAD) implantation. 45.8{\%} of the fatal events and 52.4{\%} of HT/VAD implantations occurred within 180 days after admission. Increasing age (p = .012), obesity (p = .037), atrial fibrillation (p = .030), CHD (p = .015), CLD (p = .001), RI (p ",
keywords = "Acute decompensated heart failure, Comorbidity, Mortality",
author = "D. Scrutinio and A. Passantino and P. Guida and E. Ammirati and F. Oliva and S.S. Braga and {La Rovere}, M.T. and R. Lagioia and M. Frigerio",
note = "Export Date: 14 March 2017 CODEN: EJIME Correspondence Address: Scrutinio, D.; Fondazione “S. Maugeri”, IRCCS, Istituto di Cassano Murge, Cassano Murge, Italy; email: domenico.scrutinio@fsm.it References: Mozaffarian, D., Benjamin, E.J., Go, A.S., Arnett, D.K., Blaha, M.J., Cushman, M., Heart disease and stroke statistics—2015 update: a report from the American Heart Association (2015) Circulation, 131, pp. e29-e322; Ambrosy, A.P., Fonarow, G.C., Butler, J., Chioncel, O., Greene, S.J., Vaduganathan, M., The global health and economic burden of hospitalizations for heart failure: lessons learned from hospitalized heart failure registries (2014) J Am Coll Cardiol, 63, pp. 1123-1133; Joynt, K.E., Orav, E.J., Jha, A.K., Physician volume, specialty, and outcomes of care for patients with heart failure (2013) Circ Heart Fail, 6, pp. 890-897; Gheorghiade, M., Shah, A.N., Vaduganathan, M., Butler, J., Bonow, R.O., Rosano, G.M., Recognizing hospitalized heart failure as an entity and developing new therapies to improve outcomes: academics', clinicians', industry's, regulators', and payers’ perspectives (2013) Heart Fail Clin, 9, pp. 285-290; Marti, C.N., Fonarow, G.C., Gheorghiade, M., Butler, J., Timing and duration of interventions in clinical trials for patients with hospitalized heart failure (2013) Circ Heart Fail, 6, pp. 1095-1101; Solomon, S.D., Dobson, J., Pocock, S., Skali, H., McMurray, J.J., Granger, C.B., Influence of nonfatal hospitalization for heart failure on subsequent mortality in patients with chronic heart failure (2007) Circulation, 116, pp. 1482-1487; Chen, J., Normand, S.L., Wang, Y., Krumholz, H.M., National and regional trends in heart failure hospitalization and mortality rates for Medicare beneficiaries, 1998–2008 (2011) JAMA, 306, pp. 1669-1678; Goldberg, R.J., Ciampa, J., Lessard, D., Meyer, T.E., Spencer, F.A., Long-term survival after heart failure: a contemporary population-based perspective (2007) Arch Intern Med, 167, pp. 490-496; McMurray, J.J., Adamopoulos, S., Anker, S.D., Auricchio, A., B{\"o}hm, M., Dickstein, K., ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC (2012) Eur Heart J, 33, pp. 1787-1847; Shaffer, J.A., Maurer, M.S., Multiple chronic conditions and heart failure: overlooking the obvious? (2015) JACC Heart Fail, 3, pp. 551-553; Arnett, D.K., Goodman, R.A., Halperin, J.L., Anderson, J.L., Parekh, A.K., Zoghbi, W.A., AHA/ACC/HHS strategies to enhance application of clinical practice guidelines in patients with cardiovascular disease and comorbid conditions: from the American Heart Association, American College of Cardiology, and US Department of Health and Human Services (2014) Circulation, 130, pp. 1662-1667; Boyd, C.M., Landefeld, C.S., Counsell, S.R., Palmer, R.M., Fortinsky, R.H., Kresevic, D., Recovery of activities of daily living in older adults after hospitalization for acute medical illness (2008) J Am Geriatr Soc, 56, pp. 2171-2179; Ather, S., Chan, W., Bozkurt, B., Aguilar, D., Ramasubbu, K., Zachariah, A.A., Impact of noncardiac comorbidities on morbidity and mortality in a predominantly male population with heart failure and preserved versus reduced ejection fraction (2012) J Am Coll Cardiol, 59, pp. 998-1005; Mentz, R.J., Kelly, J.P., von Lueder, T.G., Voors, A.A., Lam, C.S., Cowie, M.R., Noncardiac comorbidities in heart failure with reduced versus preserved ejection fraction (2014) J Am Coll Cardiol, 64, pp. 2281-2293; Yancy, C.W., Jessup, M., Bozkurt, B., Butler, J., Casey, D.E., Jr., Drazner, M.H., 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines (2013) Circulation, 128, pp. e240-e327; Mentz, R.J., Felker, G.M., Noncardiac comorbidities and acute heart failure patients (2013) Heart Fail Clin, 9, pp. 359-367; Ouwerkerk, W., Voors, A.A., Zwinderman, A.H., Factors influencing the predictive power of models for predicting mortality and/or heart failure hospitalization in patients with heart failure (2014) JACC Heart Fail, 2, pp. 429-436; Harjola, V.P., Follath, F., Nieminen, M.S., Brutsaert, D., Dickstein, K., Drexler, H., Characteristics, outcomes, and predictors of mortality at 3 months and 1 year in patients hospitalized for acute heart failure (2010) Eur J Heart Fail, 12, pp. 239-248; Parenica, J., Spinar, J., Vitovec, J., Widimsky, P., Linhart, A., Fedorco, M., Long-term survival following acute heart failure: the Acute Heart Failure Database Main registry (AHEAD Main) (2013) Eur J Intern Med, 24, pp. 151-160; Spinar, J., Jarkovsky, J., Spinarova, L., Mebazaa, A., Gayat, E., Vitovec, J., AHEAD score—long-term risk classification in acute heart failure (2015) Int J Cardiol, 202, pp. 21-26; Valderas, J.M., Starfield, B., Sibbald, B., Salisbury, C., Roland, M., Defining comorbidity: implications for understanding health and health services (2009) Ann Fam Med, 7, pp. 357-363; Bowles, K.H., Ratcliffe, S.J., Holmes, J.H., Liberatore, M., Nydick, R., Naylor, M.D., Post-acute referral decisions made by multidisciplinary experts compared to hospital clinicians and the patients’ 12-week outcomes (2008) Med Care, 46, pp. 158-166; Bowles, K.H., Holmes, J.H., Ratcliffe, S.J., Liberatore, M., Nydick, R., Naylor, M.D., Factors identified by experts to support decision making for post acute referral (2009) Nurs Res, 58, pp. 115-122; Tavazzi, L., Senni, M., Metra, M., Gorini, M., Cacciatore, G., Chinaglia, A., Multicenter prospective observational study on acute and chronic heart failure: one-year follow-up results of IN-HF (Italian Network on Heart Failure) Outcome Registry (2013) Circ Heart Fail, 6, p. 473-48; Lee, D.S., Austin, P.C., Rouleau, J.L., Liu, P.P., Naimark, D., Tu, J.V., Predicting mortality among patients hospitalized for heart failure: derivation and validation of a clinical model (2003) JAMA, 290, pp. 2581-2587; Khand, A.U., Gemmell, I., Rankin, A.C., Cleland, J.G., Clinical events leading to the progression of heart failure: insights from a national database of hospital discharges (2001) Eur Heart J, 22, pp. 153-164; Fonarow, G.C., Abraham, W.T., Albert, N.M., Stough, W.G., Gheorghiade, M., Greenberg, B.H., Factors identified as precipitating hospital admissions for heart failure and clinical outcomes: findings from OPTIMIZE-HF (2008) Arch Intern Med, 168, pp. 847-854; {\O}rn, S., Cleland, J.G., Romo, M., Kjekshus, J., Dickstein, K., Recurrent infarction causes the most deaths following myocardial infarction with left ventricular dysfunction (2005) Am J Med, 118, pp. 752-758; Uretsky, B.F., Thygesen, K., Armstrong, P.W., Cleland, J.G., Horowitz, J.D., Massie, B.M., Acute coronary findings at autopsy in heart failure patients with sudden death: results from the assessment of treatment with lisinopril and survival (ATLAS) trial (2000) Circulation, 102, pp. 611-616; Beohar, N., Erdogan, A.K., Lee, D.C., Sabbah, H.N., Kern, M.J., Teerlink, J., Acute heart failure syndromes and coronary perfusion (2008) J Am Coll Cardiol, 52, pp. 13-16; Greig, D., Austin, P.C., Zhou, L., Tu, J.V., Pang, P.S., Ross, H.J., Ischemic electrocardiographic abnormalities and prognosis in decompensated heart failure (2014) Circ Heart Fail, 7, pp. 986-993; Peacock, W.F., 4th, De Marco, T., Fonarow, G.C., Diercks, D., Wynne, J., Apple, F.S., Cardiac troponin and outcome in acute heart failure (2008) N Engl J Med, 358, pp. 2117-2126; Metra, M., Cotter, G., Davison, B.A., Felker, G.M., Filippatos, G., Greenberg, B.H., Effect of serelaxin on cardiac, renal, and hepatic biomarkers in the Relaxin in Acute Heart Failure (RELAX-AHF) development program: correlation with outcomes (2013) J Am Coll Cardiol, 61, pp. 196-206; Drexler, B., Heinisch, C., Balmelli, C., Lassus, J., Siiril{\"a}-Waris, K., Arenja, N., Quantifying cardiac hemodynamic stress and cardiomyocyte damage in ischemic and nonischemic acute heart failure (2012) Circ Heart Fail, 5, pp. 17-24; Flaherty, J.D., Bax, J.J., De Luca, L., Rossi, J.S., Davidson, C.J., Filippatos, G., Acute heart failure syndromes in patients with coronary artery disease early assessment and treatment (2009) J Am Coll Cardiol, 53, pp. 254-263; Flaherty, J.D., Rossi, J.S., Fonarow, G.C., Nunez, E., Stough, W.G., Abraham, W.T., Influence of coronary angiography on the utilization of therapies in patients with acute heart failure syndromes: findings from Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF) (2009) Am Heart J, 157, pp. 1018-1025; Katsanos, S., Bistola, V., Parissis, J.T., Acute heart failure syndromes in the elderly: the european perspective (2015) Heart Fail Clin, 11, pp. 637-645; von Haehling, S., Horwich, T.B., Fonarow, G.C., Anker, S.D., Tipping the scale. Heart failure, body mass index, and prognosis (2007) Circulation, 116, pp. 588-590; Fonarow, G.C., Srikanthan, P., Costanzo, M.R., Cintron, G.B., Lopatin, M., ADHERE Scientific Advisory Committee and Investigators, An obesity paradox in acute heart failure: analysis of body mass index and inhospital mortality for 108,927 patients in the Acute Decompensated Heart Failure National Registry (2007) Am Heart J, 153, pp. 74-81; Piro, M., Della Bona, R., Abbate, A., Biasucci, L.M., Crea, F., Sex-related differences in myocardial remodeling (2010) J Am Coll Cardiol, 55, pp. 1057-1065; Maggioni, A.P., Orso, F., Calabria, S., Rossi, E., Cinconze, E., Baldasseroni, S., The real-world evidence of heart failure: findings from 41 413 patients of the ARNO database (2016) Eur J Heart Fail, , [Epub ahead of print] Jan 11; Maggioni, A.P., Epidemiology of heart failure in Europe (2015) Heart Fail Clin, 11, pp. 625-635; Lavie, C.J., Milani, R.V., Ventura, H.O., Romero-Corral, A., Body composition and heart failure prevalence and prognosis: getting to the fat of the matter in the “obesity paradox” (2010) Mayo Clin Proc, 85, pp. 605-608; Shah, R., Gayat, E., Januzzi, J.L., Jr., Sato, N., Cohen-Solal, A., diSomma, S., Body mass index and mortality in acutely decompensated heart failure across the world: a global obesity paradox (2014) J Am Coll Cardiol, 63, pp. 778-785; Chong, V.H., Singh, J., Parry, H., Saunders, J., Chowdhury, F., Mancini, D.M., Management of noncardiac comorbidities in chronic heart failure (2015) Cardiovasc Ther, 33, pp. 300-315",
year = "2016",
doi = "10.1016/j.ejim.2016.05.020",
language = "English",
volume = "34",
pages = "63--67",
journal = "European Journal of Internal Medicine",
issn = "0953-6205",
publisher = "Elsevier B.V.",

}

TY - JOUR

T1 - Prognostic impact of comorbidities in hospitalized patients with acute exacerbation of chronic heart failure

AU - Scrutinio, D.

AU - Passantino, A.

AU - Guida, P.

AU - Ammirati, E.

AU - Oliva, F.

AU - Braga, S.S.

AU - La Rovere, M.T.

AU - Lagioia, R.

AU - Frigerio, M.

N1 - Export Date: 14 March 2017 CODEN: EJIME Correspondence Address: Scrutinio, D.; Fondazione “S. Maugeri”, IRCCS, Istituto di Cassano Murge, Cassano Murge, Italy; email: domenico.scrutinio@fsm.it References: Mozaffarian, D., Benjamin, E.J., Go, A.S., Arnett, D.K., Blaha, M.J., Cushman, M., Heart disease and stroke statistics—2015 update: a report from the American Heart Association (2015) Circulation, 131, pp. e29-e322; Ambrosy, A.P., Fonarow, G.C., Butler, J., Chioncel, O., Greene, S.J., Vaduganathan, M., The global health and economic burden of hospitalizations for heart failure: lessons learned from hospitalized heart failure registries (2014) J Am Coll Cardiol, 63, pp. 1123-1133; Joynt, K.E., Orav, E.J., Jha, A.K., Physician volume, specialty, and outcomes of care for patients with heart failure (2013) Circ Heart Fail, 6, pp. 890-897; Gheorghiade, M., Shah, A.N., Vaduganathan, M., Butler, J., Bonow, R.O., Rosano, G.M., Recognizing hospitalized heart failure as an entity and developing new therapies to improve outcomes: academics', clinicians', industry's, regulators', and payers’ perspectives (2013) Heart Fail Clin, 9, pp. 285-290; Marti, C.N., Fonarow, G.C., Gheorghiade, M., Butler, J., Timing and duration of interventions in clinical trials for patients with hospitalized heart failure (2013) Circ Heart Fail, 6, pp. 1095-1101; Solomon, S.D., Dobson, J., Pocock, S., Skali, H., McMurray, J.J., Granger, C.B., Influence of nonfatal hospitalization for heart failure on subsequent mortality in patients with chronic heart failure (2007) Circulation, 116, pp. 1482-1487; Chen, J., Normand, S.L., Wang, Y., Krumholz, H.M., National and regional trends in heart failure hospitalization and mortality rates for Medicare beneficiaries, 1998–2008 (2011) JAMA, 306, pp. 1669-1678; Goldberg, R.J., Ciampa, J., Lessard, D., Meyer, T.E., Spencer, F.A., Long-term survival after heart failure: a contemporary population-based perspective (2007) Arch Intern Med, 167, pp. 490-496; McMurray, J.J., Adamopoulos, S., Anker, S.D., Auricchio, A., Böhm, M., Dickstein, K., ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC (2012) Eur Heart J, 33, pp. 1787-1847; Shaffer, J.A., Maurer, M.S., Multiple chronic conditions and heart failure: overlooking the obvious? (2015) JACC Heart Fail, 3, pp. 551-553; Arnett, D.K., Goodman, R.A., Halperin, J.L., Anderson, J.L., Parekh, A.K., Zoghbi, W.A., AHA/ACC/HHS strategies to enhance application of clinical practice guidelines in patients with cardiovascular disease and comorbid conditions: from the American Heart Association, American College of Cardiology, and US Department of Health and Human Services (2014) Circulation, 130, pp. 1662-1667; Boyd, C.M., Landefeld, C.S., Counsell, S.R., Palmer, R.M., Fortinsky, R.H., Kresevic, D., Recovery of activities of daily living in older adults after hospitalization for acute medical illness (2008) J Am Geriatr Soc, 56, pp. 2171-2179; Ather, S., Chan, W., Bozkurt, B., Aguilar, D., Ramasubbu, K., Zachariah, A.A., Impact of noncardiac comorbidities on morbidity and mortality in a predominantly male population with heart failure and preserved versus reduced ejection fraction (2012) J Am Coll Cardiol, 59, pp. 998-1005; Mentz, R.J., Kelly, J.P., von Lueder, T.G., Voors, A.A., Lam, C.S., Cowie, M.R., Noncardiac comorbidities in heart failure with reduced versus preserved ejection fraction (2014) J Am Coll Cardiol, 64, pp. 2281-2293; Yancy, C.W., Jessup, M., Bozkurt, B., Butler, J., Casey, D.E., Jr., Drazner, M.H., 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines (2013) Circulation, 128, pp. e240-e327; Mentz, R.J., Felker, G.M., Noncardiac comorbidities and acute heart failure patients (2013) Heart Fail Clin, 9, pp. 359-367; Ouwerkerk, W., Voors, A.A., Zwinderman, A.H., Factors influencing the predictive power of models for predicting mortality and/or heart failure hospitalization in patients with heart failure (2014) JACC Heart Fail, 2, pp. 429-436; Harjola, V.P., Follath, F., Nieminen, M.S., Brutsaert, D., Dickstein, K., Drexler, H., Characteristics, outcomes, and predictors of mortality at 3 months and 1 year in patients hospitalized for acute heart failure (2010) Eur J Heart Fail, 12, pp. 239-248; Parenica, J., Spinar, J., Vitovec, J., Widimsky, P., Linhart, A., Fedorco, M., Long-term survival following acute heart failure: the Acute Heart Failure Database Main registry (AHEAD Main) (2013) Eur J Intern Med, 24, pp. 151-160; Spinar, J., Jarkovsky, J., Spinarova, L., Mebazaa, A., Gayat, E., Vitovec, J., AHEAD score—long-term risk classification in acute heart failure (2015) Int J Cardiol, 202, pp. 21-26; Valderas, J.M., Starfield, B., Sibbald, B., Salisbury, C., Roland, M., Defining comorbidity: implications for understanding health and health services (2009) Ann Fam Med, 7, pp. 357-363; Bowles, K.H., Ratcliffe, S.J., Holmes, J.H., Liberatore, M., Nydick, R., Naylor, M.D., Post-acute referral decisions made by multidisciplinary experts compared to hospital clinicians and the patients’ 12-week outcomes (2008) Med Care, 46, pp. 158-166; Bowles, K.H., Holmes, J.H., Ratcliffe, S.J., Liberatore, M., Nydick, R., Naylor, M.D., Factors identified by experts to support decision making for post acute referral (2009) Nurs Res, 58, pp. 115-122; Tavazzi, L., Senni, M., Metra, M., Gorini, M., Cacciatore, G., Chinaglia, A., Multicenter prospective observational study on acute and chronic heart failure: one-year follow-up results of IN-HF (Italian Network on Heart Failure) Outcome Registry (2013) Circ Heart Fail, 6, p. 473-48; Lee, D.S., Austin, P.C., Rouleau, J.L., Liu, P.P., Naimark, D., Tu, J.V., Predicting mortality among patients hospitalized for heart failure: derivation and validation of a clinical model (2003) JAMA, 290, pp. 2581-2587; Khand, A.U., Gemmell, I., Rankin, A.C., Cleland, J.G., Clinical events leading to the progression of heart failure: insights from a national database of hospital discharges (2001) Eur Heart J, 22, pp. 153-164; Fonarow, G.C., Abraham, W.T., Albert, N.M., Stough, W.G., Gheorghiade, M., Greenberg, B.H., Factors identified as precipitating hospital admissions for heart failure and clinical outcomes: findings from OPTIMIZE-HF (2008) Arch Intern Med, 168, pp. 847-854; Ørn, S., Cleland, J.G., Romo, M., Kjekshus, J., Dickstein, K., Recurrent infarction causes the most deaths following myocardial infarction with left ventricular dysfunction (2005) Am J Med, 118, pp. 752-758; Uretsky, B.F., Thygesen, K., Armstrong, P.W., Cleland, J.G., Horowitz, J.D., Massie, B.M., Acute coronary findings at autopsy in heart failure patients with sudden death: results from the assessment of treatment with lisinopril and survival (ATLAS) trial (2000) Circulation, 102, pp. 611-616; Beohar, N., Erdogan, A.K., Lee, D.C., Sabbah, H.N., Kern, M.J., Teerlink, J., Acute heart failure syndromes and coronary perfusion (2008) J Am Coll Cardiol, 52, pp. 13-16; Greig, D., Austin, P.C., Zhou, L., Tu, J.V., Pang, P.S., Ross, H.J., Ischemic electrocardiographic abnormalities and prognosis in decompensated heart failure (2014) Circ Heart Fail, 7, pp. 986-993; Peacock, W.F., 4th, De Marco, T., Fonarow, G.C., Diercks, D., Wynne, J., Apple, F.S., Cardiac troponin and outcome in acute heart failure (2008) N Engl J Med, 358, pp. 2117-2126; Metra, M., Cotter, G., Davison, B.A., Felker, G.M., Filippatos, G., Greenberg, B.H., Effect of serelaxin on cardiac, renal, and hepatic biomarkers in the Relaxin in Acute Heart Failure (RELAX-AHF) development program: correlation with outcomes (2013) J Am Coll Cardiol, 61, pp. 196-206; Drexler, B., Heinisch, C., Balmelli, C., Lassus, J., Siirilä-Waris, K., Arenja, N., Quantifying cardiac hemodynamic stress and cardiomyocyte damage in ischemic and nonischemic acute heart failure (2012) Circ Heart Fail, 5, pp. 17-24; Flaherty, J.D., Bax, J.J., De Luca, L., Rossi, J.S., Davidson, C.J., Filippatos, G., Acute heart failure syndromes in patients with coronary artery disease early assessment and treatment (2009) J Am Coll Cardiol, 53, pp. 254-263; Flaherty, J.D., Rossi, J.S., Fonarow, G.C., Nunez, E., Stough, W.G., Abraham, W.T., Influence of coronary angiography on the utilization of therapies in patients with acute heart failure syndromes: findings from Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF) (2009) Am Heart J, 157, pp. 1018-1025; Katsanos, S., Bistola, V., Parissis, J.T., Acute heart failure syndromes in the elderly: the european perspective (2015) Heart Fail Clin, 11, pp. 637-645; von Haehling, S., Horwich, T.B., Fonarow, G.C., Anker, S.D., Tipping the scale. Heart failure, body mass index, and prognosis (2007) Circulation, 116, pp. 588-590; Fonarow, G.C., Srikanthan, P., Costanzo, M.R., Cintron, G.B., Lopatin, M., ADHERE Scientific Advisory Committee and Investigators, An obesity paradox in acute heart failure: analysis of body mass index and inhospital mortality for 108,927 patients in the Acute Decompensated Heart Failure National Registry (2007) Am Heart J, 153, pp. 74-81; Piro, M., Della Bona, R., Abbate, A., Biasucci, L.M., Crea, F., Sex-related differences in myocardial remodeling (2010) J Am Coll Cardiol, 55, pp. 1057-1065; Maggioni, A.P., Orso, F., Calabria, S., Rossi, E., Cinconze, E., Baldasseroni, S., The real-world evidence of heart failure: findings from 41 413 patients of the ARNO database (2016) Eur J Heart Fail, , [Epub ahead of print] Jan 11; Maggioni, A.P., Epidemiology of heart failure in Europe (2015) Heart Fail Clin, 11, pp. 625-635; Lavie, C.J., Milani, R.V., Ventura, H.O., Romero-Corral, A., Body composition and heart failure prevalence and prognosis: getting to the fat of the matter in the “obesity paradox” (2010) Mayo Clin Proc, 85, pp. 605-608; Shah, R., Gayat, E., Januzzi, J.L., Jr., Sato, N., Cohen-Solal, A., diSomma, S., Body mass index and mortality in acutely decompensated heart failure across the world: a global obesity paradox (2014) J Am Coll Cardiol, 63, pp. 778-785; Chong, V.H., Singh, J., Parry, H., Saunders, J., Chowdhury, F., Mancini, D.M., Management of noncardiac comorbidities in chronic heart failure (2015) Cardiovasc Ther, 33, pp. 300-315

PY - 2016

Y1 - 2016

N2 - Background To assess the impact of comorbidities on long-term all-cause mortality in patients hospitalized with exacerbated signs/symptoms of previously chronic stable HF (AE-CHF). Methods 1119 patients admitted for AE-CHF and with NT-proBNP levels > 900 pg/mL were enrolled. Univariable and multivariable Cox analyses were performed to assess the association of age, gender, hypertension, diabetes, obesity, atrial fibrillation, coronary heart disease (CHD), chronic obstructive pulmonary disease, previous cerebrovascular accidents, chronic liver disease (CLD), thyroid disease, renal impairment (RI), and anemia with 3-year all-cause mortality. Results During the follow-up, 441 patients died and 126 underwent heart transplantation (HT) or ventricular assist device (VAD) implantation. 45.8% of the fatal events and 52.4% of HT/VAD implantations occurred within 180 days after admission. Increasing age (p = .012), obesity (p = .037), atrial fibrillation (p = .030), CHD (p = .015), CLD (p = .001), RI (p 

AB - Background To assess the impact of comorbidities on long-term all-cause mortality in patients hospitalized with exacerbated signs/symptoms of previously chronic stable HF (AE-CHF). Methods 1119 patients admitted for AE-CHF and with NT-proBNP levels > 900 pg/mL were enrolled. Univariable and multivariable Cox analyses were performed to assess the association of age, gender, hypertension, diabetes, obesity, atrial fibrillation, coronary heart disease (CHD), chronic obstructive pulmonary disease, previous cerebrovascular accidents, chronic liver disease (CLD), thyroid disease, renal impairment (RI), and anemia with 3-year all-cause mortality. Results During the follow-up, 441 patients died and 126 underwent heart transplantation (HT) or ventricular assist device (VAD) implantation. 45.8% of the fatal events and 52.4% of HT/VAD implantations occurred within 180 days after admission. Increasing age (p = .012), obesity (p = .037), atrial fibrillation (p = .030), CHD (p = .015), CLD (p = .001), RI (p 

KW - Acute decompensated heart failure

KW - Comorbidity

KW - Mortality

U2 - 10.1016/j.ejim.2016.05.020

DO - 10.1016/j.ejim.2016.05.020

M3 - Article

VL - 34

SP - 63

EP - 67

JO - European Journal of Internal Medicine

JF - European Journal of Internal Medicine

SN - 0953-6205

ER -