5-year Follow-up And Prognosis Analysis Of A Single-center Acute Heart Failure Registry Study

Background:Heart failure(HF)is the serious and terminal stage of various cardiac disease,with the characteristic of high morbidity,high rehospitalization rate and high mortality.The emergency room(ER)play an important role in the treatment of heart failure.There is no domestic large register study on heart failure patients in ER and lack of research on the long-term prognosis and treatment status in heart failure patients.Beijing Acute Heart Failure(AHF)Registry is the first prospective,multicenter,cohort study on the heart failure patients in ER in China.The study included demographic data,epidemiological characteristics and data on survival condition,treatment,and disease outcome collected after long term follow-up,and further analyzed the risk factors affecting the 5-year prognosis.Objective:This study aims to observe the 5-year prognosis and treatment status of heart failure patients in ER of Fuwai hospital,compare the difference of 5-year prognosis between various factors,and explore the risk factors affecting the 5-year prognosis of patients with AHF in ER of Fuwai hospital.Methods:1032 patients from ER of Fuwai hospital included in Beijing AHF Registry were followed up for 5 years by the way of telephone,outpatient record and checking ID number.We collected data on 5-year survival and treatment conditions,summarized the 5-year mortality and treatment status.The data was analyzed by SPSS.We compared the difference of 5-year prognosis between various factors,and explored the risk factors affecting the 5-year prognosis.Results:A total of 1032 AHF patients from ER of Fuwai hospital between March 15,2011 and April 27,2012were analyzed.The average age of patients was at 56.9±15.6 years with female 38%.The patients were followed up 5 years.The lost rate of follow-up was 4%.The 1-year mortality was 25.2%,the 3-year mortality was 38.9%and the 5-year mortality was 42.8%.There were 45.2%patients treated by ? blockers,17.1%patients received angiotensin converting angiotensin inhibitor(ACEI),10.2%patients received angiotensin receptor blocker(ARB),and 26.9%patients treated by mineralocorticoid receptor antagonists(MRA).There was statistical significant difference in the Kaplan-Meier analysis between factors including age,BMI,cardiac function,chronic renal failure,NT-proBNP,neuroendocrine blockers,digoxin and diuretic.But there was no significant difference of long-term prognosis in digoxin and diuretic after adjusting confounders.The 5-year prognosis between heart failure with preserved ejection fraction(HFpEF)?heart failure with mid-range ejection fraction(HFmrEF)and heart failure with reduced ejection fraction(HFrEF)was similar as well as new-onset acute heart failure and worsening chronic heart failure.Multivariable COX regression analysis suggested the risk factors of 5-year all-cause mortality among AHF patients in ER of Fuwai hospital including age,lower BMI,higher NYHA classification,reduced SBP,high level of serum creatinine and NT-proBNP.Conclusion:The prognosis of AHF patients was poor.There was still a gap for medications between our current condition and the guideline.The risk factors of 5-year all-cause mortality among AHF patients were advanced age,lower BMI,higher NYHA classification,reduced SBP,high level of serum creatinine and NT-proBNP.