The Clinical Parameters In All-cause Mortality In Chronic Heart Failure Predictive Value

Aging and low body mass index (BM1) may predict higher mortality in patients with chronic heart failureObjectives To investigate the predictive value of age and body mass index(BMI) for all-cause death in patients with chronic heart failure (CHF) Methods1197consecutive patients with CHF admitted in Fu Wai Cardiovascular Hospital were recruited. Among which706cases were ischaemic cardiomyopathy (ICM) and491cases were dilated cardiomyopathy(DCM).The study population was followed up until Dec2010either by telephone contact or out-patient visit. The end point was all-cause death. Analysis of variance was used for continuous data when comparing the age/BMI levels and chi-square test was used to compare categorical data. We performed survival analysis on the successful follow-up CHF population.Kaplan-Meier plots were used to describe survival during the observation period in different patient groups. Log-rank test was used to identify differences between groups. Univariate Cox regression analyses were performed in estimating Hazard ratios (HRs) for time to cardiac death and statistically significant predictors of mortality at baseline were entered into the multivariate Cox regression model to reveal the predictive significance of age, as well as BMI.Results During a median follow-up period of44months,1025cases were successful to follow-up.360individuals died and665cases survived. Statistical Differences were found in co-morbidity, blood pressure, LVEF, laboratory results and medication between the age groups.Advancing age and lower BMI increased all-cause mortality in patients with CHF. After adjusted for other risk factors, age and BMI remained independent predictors of mortality in CHF patients.Conclusions In a univariate analysis, male, high BMI, LVEF,SBP and DBP, history of hypertension and hyperlipemia were protective factors,while advancing age and history of VT were risk factors in predicting higher mortality in patients with CHF. A multivariate analysis demonstrated that aging and lower BMI, lower LVEF, history of VT were independent factors associated with worse survival. Advancing age and Lower BMI were new baseline parameters independently predicting mortality in patients of CHF. Lower Hemoglobin concentration and higher total bilirubin may predict higher mortality in patients with chronic heart failureObjectives To investigate the predictive value of Hemoglobin (Hb) and total bilirubin(Tbil) for all-cause death in patients with chronic heart failure (CHF) Methods1197consecutive patients with CHF admitted in Fu Wai Cardiovascular Hospital were recruited. Among which706cases were ischaemic cardiomyopathy (ICM) and491cases were dilated cardiomyopathy(DCM).The study population was followed up until Dec2010either by telephone contact or out-patient visit. The end point was all-cause death. Analysis of variance and independent t-test were used for continuous data when comparing the hemoglobin/bilirubin levels and chi-square test was used to compare categorical data. We performed survival analysis on the successful follow-up CHF population. Kaplan-Meier plots were used to describe survival during the observation period in different patient groups. Log-rank test was used to identify differences of survival between groups. Univariate Cox regression analyses were performed in estimating Hazard ratios (HRs) for time to cardiac death and statistically significant predictors of mortality at baseline were entered into the multivariate Cox regression model to reveal the predictive significance of hemoglobin, as well as total bilirubin.Results During a median follow-up period of44months,1025cases were successful to follow-up.360individuals died and665cases survived. Statistical Differences were found in co-morbidity, blood pressure, LVEF, laboratory results and medication between the Hb/Tbil groups.Lower Hb and higher Tbil increased cardiac mortality in patients with CHF. After adjusted for other risk factors, Hb and Tbil remained independent predictors of mortality in CHF patients.Conclusions In a univariate analysis, parameters of laboratory examination including Tbil, potassium, serum creatinine(Scr],bbod urea nitrogen[BUN), uric acid(UA) were all risk factors,while Hb, albumin(ALB] and sodium, triglyceride, high-density lipoprotein were protective factors in predicting higher mortality in patients with CHF. A multivariate analysis demonstrated that lower hemoglobin and higher Tbil, higher UA were independent factors associated with worse survival. Higher Tbil and Lower Hb were new laboratory parameters independently predicting mortality in patients of CHF. Chronic use of loop diuretics may predict worse outcome in patients with chronic heart failureObjectives To investigate whether chronic use of oral loop diuretic could identify patients with chronic heart failure (CHF) of adverse prognosis.Methods1197consecutive patients with CHF admitted in Fu Wai Cardiovascular Hospital were recruited. Among which706cases were ischaemic cardiomyopathy (ICM) and491cases were dilated cardiomyopathy(DCM).The study population was followed up until Dec2010either by telephone contact or out-patient visit. The end point was all-cause death. Analysis of variance were used for continuous data when comparing the levels of loop-diuretic dosage and chi-square test was used to compare categorical data. We performed survival analysis on the successful follow-up CHF population. Kaplan-Meier plots were used to describe survival during the observation period in different patient groups. Log-rank test was used to identify differences of survival between groups. Univariate Cox regression analyses were performed in estimating Hazard ratios (HRs) for time to death and statistically significant predictors of mortality at baseline were entered into the multivariate Cox regression model to reveal the predictive significance of medication of loop diuretic.Results During a median follow-up period of44months,1025cases were successful to follow-up.360individuals died and665cases survived. Statistical Differences were found in co-morbidity, blood pressure, LVEF, laboratory results and medication between the different dosage groups.Use of Higher-dose loop-diuretic increased all-cause mortality in patients with CHF. After adjusted for other risk factors, chronic use of Loop-diuretic remained predictors of mortality in CHF patients.Conclusions. In a univariate analysis, medication of spironolactone, loop diuretic were risk factors,while use of aspirin and statins were protective factors in predicting higher mortality in patients with CHF. Adjusted for other factors, use of ACEI/ARB was a favorable factor independently associated with better survival. Chronic use of Loop diuretic was independent factors in predicting worse outcomes in patients with CHF.