Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
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Characteristics, Outcomes and Predictors of Long-Term Mortality for Patients Hospitalized for Acute Heart Failure: A Report From the Korean Heart Failure Registry

  • Choi, Dong-Ju (Department of Internal Medicine, Seoul National University College of Medicine, Bundang Hospital) ;
  • Han, Seong-Woo (Department Internal Medicine, Korea University College of Medicine) ;
  • Jeon, Eun-Seok (Department of Internal Medicine, Sungkyunkwan University College of Medicine, Samsung Medical Center) ;
  • Cho, Myeong-Chan (Department of Internal Medicine, Chungbuk National University College of Medicine) ;
  • Kim, Jae-Joong (Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Yoo, Byung-Su (Department of Internal Medicine, Yonsei University Wonju Christian Hospital) ;
  • Shin, Mi-Seung (Department of Internal Medicine, Gachon University Gil Hospital) ;
  • Seong, In-Whan (Department of Internal Medicine, Chungnam National University College of Medicine) ;
  • Ahn, Young-Keun (Department of Internal Medicine, Chonnam National University College of Medicine) ;
  • Kang, Seok-Min (Department of Internal Medicine, Yonsei University Severance Hospital) ;
  • Kim, Yung-Jo (Department of Internal Medicine, Yeungnam University College of Medicine) ;
  • Kim, Hyung-Seop (Department of Internal Medicine, Keimyung University College of Medicine) ;
  • Chae, Shung-Chull (Department of Internal Medicine, Kyungpook National University College of Medicine) ;
  • Oh, Byung-Hee (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Lee, Myung-Mook (Department of Internal Medicine, Dongguk University College of Medicine, Ilsan Hospital) ;
  • Ryu, Kyu-Hyung (Department of Internal Medicine, Konkuk University Medical Center) ;
  • The KorHF Registry, The KorHF Registry (The KorHF Registry)
  • Published : 2011.07.30
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Abstract

Background and Objectives: Acute heart failure (AHF) is associated with a poor prognosis and it requires repeated hospitalizations. However, there are few studies on the characteristics, treatment and prognostic factors of AHF. The aims of this study were to describe the clinical characteristics, management and outcomes of the patients hospitalized for AHF in Korea. Subjects and Methods: We analyzed the clinical data of 3,200 hospitalization episodes that were recorded between June 2004 and April 2009 from the Korean Heart Failure (KorHF) Registry database. The mean age was 67.6${\pm}$14.3 years and 50% of the patients were female. Results: Twenty-nine point six percent (29.6%) of the patients had a history of previous HF and 52.3% of the patients had ischemic heart disease. Left ventricular ejection fraction (LVEF) was reported for 89% of the patients. The mean LVEF was 38.5${\pm}$15.7% and 26.1% of the patients had preserved systolic function (LVEF ${\geq}$50%), which was more prevalent in the females (34.0% vs. 18.4%, respectively, p<0.001). At discharge, 58.6% of the patients received beta-blockers (BB), 53.7% received either angiotensin converting enzyme-inhibitors or angiotensin receptor blockers (ACEi/ARB), and 58.4% received both BB and ACEi/ARB. The 1-, 2-, 3- and 4-year mortality rates were 15%, 21%, 26% and 30%, respectively. Multivariate analysis revealed that advanced age {hazard ratio: 1.023 (95% confidence interval: 1.004-1.042); p=0.020}, a previous history of heart failure {1.735 (1.150-2.618); p=0.009}, anemia {1.973 (1.271-3.063); p=0.002}, hyponatremia {1.861 (1.184-2.926); p= 0.007}, a high level of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) {3.152 (1.450-6.849); p=0.004} and the use of BB at discharge {0.599 (0.360-0.997); p=0.490} were significantly associated with total death. Conclusion: We present here the characteristics and prognosis of an unselected population of AHF patients in Korea. The long-term mortality rate was comparable to that reported in other countries. The independent clinical risk factors included age, a previous history of heart failure, anemia, hyponatremia, a high NT-proBNP level and taking BB at discharge.

Keywords

References

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