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Patient-reported and Clinical Outcomes Among Patients Hospitalized for Heart Failure With Reduced Versus Preserved Ejection Fraction.

Publication ,  Journal Article
Peters, AE; Mentz, RJ; Sun, J-L; Harrington, JL; Fudim, M; Alhanti, B; Hernandez, AF; Butler, J; Starling, RC; Greene, SJ
Published in: J Card Fail
December 2022

BACKGROUND: Differences between patients hospitalized for heart failure with reduced ejection fraction (HFrEF) vs HF with preserved EF (HFpEF) are not well-characterized, particularly as pertains to in-hospital decongestion and longitudinal patient-reported outcomes. The objective of this analysis was to compare patient-reported and clinical outcomes between patients hospitalized with HFrEF vs HFpEF. METHODS AND RESULTS: The Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure (ASCEND-HF) trial enrolled 7141 patients hospitalized for HF with reduced or preserved EF. We assessed the association between an EF ≤ 40% vs an EF >40% with in-hospital decongestion, risk of rehospitalization and mortality, and quality of life as measured by the EuroQOL 5 Dimensions (EQ-5D). Among 5800 patients (81%) with complete EF data, 4782 (82%) had an EF ≤40% and 1018 (18%) had an EF >40%. Both groups demonstrated similar rates of decongestion by weight change and urine volume through 24 hours, a similar risk of 30-day mortality and HF rehospitalization, and a similar 180-day mortality. Patients with HFpEF had worse EQ-5D scores at hour 24 (median 0.76, [interquartile range (IQR) 0.51-0.84] vs 0.78 [IQR 0.57-0.84]; P = .01) that persisted through discharge (0.81 [IQR 0.69-0.86] vs 0.83 [IQR 0.71-1.00]; P < .001) and the 30-day follow-up (0.78 [IQR 0.60-0.85] vs 0.83 [IQR 0.71-1.00]; P < .001). After adjustment, these differences were attenuated and not statistically significant. CONCLUSIONS: In this large, multinational cohort of patients hospitalized for HF, patients with an EF ≤ 40% vs an EF >40% experienced similar in-hospital decongestion and postdischarge clinical outcomes. Patients with an EF >40% reported worse in-hospital and postdischarge patient-reported health status, but these measures were similar to HFrEF after accounting for other clinical factors.

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Published In

J Card Fail

DOI

EISSN

1532-8414

Publication Date

December 2022

Volume

28

Issue

12

Start / End Page

1652 / 1660

Location

United States

Related Subject Headings

  • Stroke Volume
  • Quality of Life
  • Prognosis
  • Patient Reported Outcome Measures
  • Patient Discharge
  • Humans
  • Hospitalization
  • Heart Failure
  • Cardiovascular System & Hematology
  • Aftercare
 

Citation

APA
Chicago
ICMJE
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Peters, A. E., Mentz, R. J., Sun, J.-L., Harrington, J. L., Fudim, M., Alhanti, B., … Greene, S. J. (2022). Patient-reported and Clinical Outcomes Among Patients Hospitalized for Heart Failure With Reduced Versus Preserved Ejection Fraction. J Card Fail, 28(12), 1652–1660. https://doi.org/10.1016/j.cardfail.2022.05.010
Peters, Anthony E., Robert J. Mentz, Jie-Lena Sun, Josephine L. Harrington, Marat Fudim, Brooke Alhanti, Adrian F. Hernandez, Javed Butler, Randall C. Starling, and Stephen J. Greene. “Patient-reported and Clinical Outcomes Among Patients Hospitalized for Heart Failure With Reduced Versus Preserved Ejection Fraction.J Card Fail 28, no. 12 (December 2022): 1652–60. https://doi.org/10.1016/j.cardfail.2022.05.010.
Peters AE, Mentz RJ, Sun J-L, Harrington JL, Fudim M, Alhanti B, et al. Patient-reported and Clinical Outcomes Among Patients Hospitalized for Heart Failure With Reduced Versus Preserved Ejection Fraction. J Card Fail. 2022 Dec;28(12):1652–60.
Peters, Anthony E., et al. “Patient-reported and Clinical Outcomes Among Patients Hospitalized for Heart Failure With Reduced Versus Preserved Ejection Fraction.J Card Fail, vol. 28, no. 12, Dec. 2022, pp. 1652–60. Pubmed, doi:10.1016/j.cardfail.2022.05.010.
Peters AE, Mentz RJ, Sun J-L, Harrington JL, Fudim M, Alhanti B, Hernandez AF, Butler J, Starling RC, Greene SJ. Patient-reported and Clinical Outcomes Among Patients Hospitalized for Heart Failure With Reduced Versus Preserved Ejection Fraction. J Card Fail. 2022 Dec;28(12):1652–1660.
Journal cover image

Published In

J Card Fail

DOI

EISSN

1532-8414

Publication Date

December 2022

Volume

28

Issue

12

Start / End Page

1652 / 1660

Location

United States

Related Subject Headings

  • Stroke Volume
  • Quality of Life
  • Prognosis
  • Patient Reported Outcome Measures
  • Patient Discharge
  • Humans
  • Hospitalization
  • Heart Failure
  • Cardiovascular System & Hematology
  • Aftercare