PMID- 34224408
OWN - NLM
STAT- MEDLINE
DCOM- 20210818
LR  - 20220531
IS  - 2542-5641 (Electronic)
IS  - 0366-6999 (Print)
IS  - 0366-6999 (Linking)
VI  - 134
IP  - 15
DP  - 2021 Jun 30
TI  - Long-term outcomes and independent predictors of mortality in patients presenting 
      to emergency departments with acute heart failure in Beijing: a multicenter 
      cohort study with a 5-year follow-up.
PG  - 1803-1811
LID - 10.1097/CM9.0000000000001617 [doi]
AB  - BACKGROUND: Acute heart failure (AHF) is the most common disease in emergency 
      departments (EDs). However, clinical data exploring the outcomes of patients 
      presenting AHF in EDs are limited, especially the long-term outcomes. The 
      purposes of this study were to describe the long-term outcomes of patients with 
      AHF in the EDs and further analyze their prognostic factors. METHODS: This 
      prospective, multicenter, cohort study consecutively enrolled 3335 patients with 
      AHF who were admitted to EDs of 14 hospitals from Beijing between January 1, 2011 
      and September 23, 2012. Kaplan-Meier and Cox regression analysis were adopted to 
      evaluate 5-year outcomes and associated predictors. RESULTS: The 5-year mortality 
      and cardiovascular death rates were 55.4% and 49.6%, respectively. The median 
      overall survival was 34 months. Independent predictors of 5-year mortality were 
      patient age (hazard ratio [HR]: 1.027, 95 confidence interval [CI]: 1.023-1.030), 
      body mass index (BMI) (HR: 0.971, 95% CI: 0.958-0.983), fatigue (HR: 1.127, 95% 
      CI: 1.009-1.258), ascites (HR: 1.190, 95% CI: 1.057-1.340), hepatic jugular 
      reflux (HR: 1.339, 95% CI: 1.140-1.572), New York Heart Association (NYHA) class 
      III to IV (HR: 1.511, 95% CI: 1.291-1.769), heart rate (HR: 1.003, 95% CI: 
      1.001-1.005), diastolic blood pressure (DBP) (HR: 0.996, 95% CI: 0.993-0.999), 
      blood urea nitrogen (BUN) (HR: 1.014, 95% CI: 1.008-1.020), B-type natriuretic 
      peptide (BNP)/N-terminal pro-B-type natriuretic peptide (NT-proBNP) level in the 
      third (HR: 1.426, 95% CI: 1.220-1.668) or fourth quartile (HR: 1.437, 95% CI: 
      1.223-1.690), serum sodium (HR: 0.980, 95% CI: 0.972-0.988), serum albumin (HR: 
      0.981, 95% CI: 0.971-0.992), ischemic heart diseases (HR: 1.195, 95% CI: 
      1.073-1.331), primary cardiomyopathy (HR: 1.382, 95% CI: 1.183-1.614), diabetes 
      (HR: 1.118, 95% CI: 1.010-1.237), stroke (HR: 1.252, 95% CI: 1.121-1.397), and 
      the use of diuretics (HR: 0.714, 95% CI: 0.626-0.814), beta-blockers (HR: 0.673, 95% 
      CI: 0.588-0.769), angiotensin-converting enzyme inhibitors (ACEIs) (HR: 0.714, 
      95% CI: 0.604-0.845), angiotensin-II receptor blockers (ARBs) (HR: 0.790, 95% CI: 
      0.646-0.965), spironolactone (HR: 0.814, 95% CI: 0.663-0.999), calcium 
      antagonists (HR: 0.624, 95% CI: 0.531-0.733), nitrates (HR: 0.715, 95% CI: 
      0.631-0.811), and digoxin (HR: 0.579, 95% CI: 0.465-0.721). CONCLUSIONS: The 
      results of our study demonstrate poor 5-year outcomes of patients presenting to 
      EDs with AHF. Age, BMI, fatigue, ascites, hepatic jugular reflux, NYHA class III 
      to IV, heart rate, DBP, BUN, BNP/NT-proBNP level in the third or fourth quartile, 
      serum sodium, serum albumin, ischemic heart diseases, primary cardiomyopathy, 
      diabetes, stroke, and the use of diuretics, beta-blockers, ACEIs, ARBs, 
      spironolactone, calcium antagonists, nitrates, and digoxin were independently 
      associated with 5-year all-cause mortality.
CI  - Copyright (c) 2021 The Chinese Medical Association, produced by Wolters Kluwer, 
      Inc. under the CC-BY-NC-ND license.
FAU - Li, Yang
AU  - Li Y
AD  - Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular 
      Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 
      Beijing 100037, China.
FAU - Sun, Xiao-Lu
AU  - Sun XL
AD  - Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular 
      Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 
      Beijing 100037, China.
FAU - Qiu, Hong
AU  - Qiu H
AD  - Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular 
      Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 
      Beijing 100037, China.
FAU - Qin, Jian
AU  - Qin J
AD  - Department of Emergency, Xuanwu Hospital, Capital Medical University, Beijing 
      100037, China.
FAU - Li, Chun-Sheng
AU  - Li CS
AD  - Department of Emergency, Beijing Chao-Yang Hospital, Capital Medical University, 
      Beijing 100020, China.
FAU - Yu, Xue-Zhong
AU  - Yu XZ
AD  - Department of Emergency, Peking Union Medical College Hospital, Beijing 100730, 
      China.
FAU - Wang, Guo-Xing
AU  - Wang GX
AD  - Department of Emergency, Beijing Friendship Hospital, Capital Medical University, 
      Beijing 100050, China.
FAU - Fu, Yan
AU  - Fu Y
AD  - Department of Emergency, Beijing Tongren Hospital, Capital Medical University, 
      Beijing 100730, China.
FAU - Zheng, Ya-An
AU  - Zheng YA
AD  - Department of Emergency, Peking University Third Hospital, Beijing 100191, China.
FAU - Zhao, Bin
AU  - Zhao B
AD  - Department of Emergency, Beijing Jishuitan Hospital, Beijing 100035, China.
FAU - Yu, Dong-Ming
AU  - Yu DM
AD  - Department of Emergency, Beijing Tiantan Hospital, Capital Medical University, 
      Beijing 100070, China.
FAU - Wang, Si-Jia
AU  - Wang SJ
AD  - Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular 
      Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 
      Beijing 100037, China.
AD  - Department of Emergency, Beijing Friendship Hospital, Capital Medical University, 
      Beijing 100050, China.
FAU - Wang, Guo-Gan
AU  - Wang GG
AD  - Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular 
      Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 
      Beijing 100037, China.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20210630
PL  - China
TA  - Chin Med J (Engl)
JT  - Chinese medical journal
JID - 7513795
RN  - 0 (Angiotensin Receptor Antagonists)
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
RN  - 0 (Biomarkers)
RN  - 0 (Peptide Fragments)
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
SB  - IM
MH  - Angiotensin Receptor Antagonists
MH  - Angiotensin-Converting Enzyme Inhibitors
MH  - Beijing/epidemiology
MH  - Biomarkers
MH  - Cohort Studies
MH  - Emergency Service, Hospital
MH  - Follow-Up Studies
MH  - *Heart Failure/mortality
MH  - Humans
MH  - Natriuretic Peptide, Brain
MH  - Peptide Fragments
MH  - Prognosis
MH  - Prospective Studies
PMC - PMC8367075
COIS- None.
EDAT- 2021/07/06 06:00
MHDA- 2021/08/19 06:00
PMCR- 2021/08/05
CRDT- 2021/07/05 17:12
PHST- 2021/07/06 06:00 [pubmed]
PHST- 2021/08/19 06:00 [medline]
PHST- 2021/07/05 17:12 [entrez]
PHST- 2021/08/05 00:00 [pmc-release]
AID - 00029330-202108050-00008 [pii]
AID - CMJ-2020-4021 [pii]
AID - 10.1097/CM9.0000000000001617 [doi]
PST - epublish
SO  - Chin Med J (Engl). 2021 Jun 30;134(15):1803-1811. doi: 
      10.1097/CM9.0000000000001617.