Survival in acute heart failure in intensive cardiac care unit: a prospective study

• DOI: 10.1007/s10554-020-02109-8
• Publication Date: 2021-01-03T22:03:09Z
• Authors: Carlotta Sciaccaluga; Giulia Elena Mandoli; Chiara Nannelli; Francesca Falciani; Cosimo Rizzo; Nicolò Sisti; Chiara Carrucola; Mariangela Vigna; Margherita Ilaria...; Eufemia Incampo; Maria Luisa Paris...; Oreste De Vivo; Francesco Contorni; Mario Stricagnoli; Antonio Pagliaro; Antonio D’Errico; Giovanni Donati; Flavio D’Ascenzi; Serafina Valente; Sergio Mondillo; Matteo Cameli
• Keywords: Male; 610; Decision Support Techniques; 618; Hemoglobins; 03 medical and health sciences; Patient Admission; 0302 clinical medicine; Predictive Value of Tests; Humans; Hospital Mortality; Aged; Aged, 80 and over; Heart Failure; Coronary Care Units; Acute heart failure; Middle Aged; Prognosis; 3. Good health; C-Reactive Protein; Echocardiography; Prognostic score; Creatinine; Acute Disease; Atrial Function, Left; Female; Acute heart failure; Echocardiography; Prognostic score; Biomarkers

The aim of this study is to identify the best predictors of mortality among clinical, biochemical and advanced echocardiographic parameters in acute heart failure (AHF) patients admitted to coronary care unit (CCU). AHF is a clinical condition characterized by high mortality and morbidity. Several studies have investigated the potential prognostic factors that could help the risk assessment of cardiovascular events in HF patients, but at the moment it has not been found a complete prognostic score (including clinical, laboratory and echocardiographic parameters), univocally used for AHF patients. Patients (n = 118) admitted to CCU due to AHF de novo or to an exacerbation of chronic heart failure were enrolled. For each patient, clinical and biochemical parameters were reported as well as the echocardiographic data, including speckle tracking echocardiography analysis. These indexes were then related to intra- and extrahospital mortality. At the end of the follow-up period, the study population was divided into two groups, defined as 'survivors' and 'non-survivors'. From statistical analysis, C-reactive protein (CRP) (AUC = 0.75), haemoglobin (AUC = 0.71), creatinine clearance (AUC = 0.74), left atrial strain (AUC = 0.73) and freewall right ventricular strain (AUC = 0.76) showed the strongest association with shortterm mortality and they represented the items of the proposed risk score, whose cut-off of 3 points is able to discriminate patients at higher risk of mortality. AHF represents one of the major challenges in CCU. The use of a combined biochemical and advanced echocardiographic score, assessed at admission, could help to better predict mortality risk, in addition to commonly used indexes.