Factors Associated With Prognosis Of De Novo Acute Heart Failure And Acute Decompensated Chronic Heart Failure

Objective:We aimed to assess the differences of clinical characteristics between patients with de novo acute heart failure(de novo HF)and acute decompensated chronic heart failure(ADCHF),and to investigate risk factors with their prognosis.Methods:We analyzed data of 125 patients with AHF,who were admitted in the Department of Cardiovascular Medcine,Fenyang Hospital affiliated to Shanxi Medical university from September 2016 to May 2018.These patients were divided into two groups(de novo AHF group and ADCHF group)according to where have a history of HF and clinical characteristics and 12 months outcomes where compared between the two groups.Endpoints were defined as re-hospitalization due to worsening heart failure and composite endpoint which include all-cause mortality and re-hospitalization due to worsening heart failure.Results:There were 47 cases(37.6%)in de-novo AHF and 78 cases(62.4%)in ADCHF.There was no significant difference in admission and discharge NT-pro BNP level between the two groups(P<0.05),but BMI,SBP,DBP,albumin,TC,HDL-C and change in NT-pro BNP of de-novo AHF were significantly higher than that of ADCHF(P<0.05).During the median follow-up period of 12 months,there were 39 cases of composite endpoint events and 18 cases of all-cause mortality.The composite endpoint events and all-cause mortality in ADCHF were higher than that in de novo AHF(40.5% vs 19.2%,and 14.9% vs 6.4%,P < 0.05).Kaplan-Meier analyses evidenced higher event-free survival rate in de novo AHF(Log-rank P = 0.003).In de novo HF group,univariate analysis showed that BUN,admission and discharge NT-pro BNP,and the change in NTpro BNP were predictors of composite endpoint events;multivariate analysis showed that BUN and discharge NT-pro BNP were predictors of composite endpoint events.In ADCHF group,univariate analysis showed that age,BUN,e GFR,admission and discharge NT-pro BNP were the predictors of the composite endpoint events;multivariate analysis showed that age and discharge NT-pro BNP were the predictors of the composite endpoint events.Conclusion:The clinical characteristics of patients with de novo HF and ADCHF were different.The change in NT-pro BNP in patients with de novo HF was higher than that in ADCHF.The change in NT-pro BNP was predictors of composite endpoint events in de novo HF,and discharged NT-pro BNP was the common predictor of both groups.