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Worsening heart failure, a critical event during hospital admission for acute heart failure: results from the VERITAS study.

Publication ,  Journal Article
Cotter, G; Metra, M; Davison, BA; Senger, S; Bourge, RC; Cleland, JGF; Jondeau, G; Krum, H; O'Connor, CM; Parker, JD; Torre-Amione, G; Milo, O ...
Published in: Eur J Heart Fail
December 2014

AIMS: Worsening heart failure (WHF) in the first 7 days after an admission for acute HF (AHF) has been proposed as a therapeutic target in several recent AHF studies and was a co-primary endpoint of the VERITAS studies. METHODS AND RESULTS: Patients were randomized within 24 h of admission for AHF. WHF was defined as worsening or persistent signs and symptoms of HF requiring additional intravenous or mechanical therapy for HF or death within 7 days of randomization. Multivariable models were developed to predict the time to WHF through day 7. Unadjusted and multivariable-adjusted associations of WHF with the length of stay (LOS) of the index hospitalization, and 30- and 90-day outcomes were estimated. WHF occurred by day 7 in 27% of the 1347 patients enrolled. Age, co-morbidities, and markers of HF severity were moderately predictive of WHF; the C-index for a multivariable model for WHF was 0.66. After multivariable adjustment for baseline characteristics, WHF was associated with an increase in LOS of 4.33 days [95% confidence interval (CI) 3.54-5.13 days], a hazard ratio (HR) for 30-day HF readmission or death of 2.43 (95% CI 1.75-3.40), and a HR for 90-day mortality of 2.57 (95% CI 1.81-3.65), all with P < 0.0001.The associations of WHF with these outcomes remained largely unchanged after adjustment for both baseline characteristics and changes in markers of renal and hepatic dysfunction during the first day of admission. CONCLUSIONS: In patients admitted for AHF, WHF is a significant clinical event that is associated with delays in discharge and higher rates for readmission and death.

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Published In

Eur J Heart Fail

DOI

EISSN

1879-0844

Publication Date

December 2014

Volume

16

Issue

12

Start / End Page

1362 / 1371

Location

England

Related Subject Headings

  • Vasodilator Agents
  • Tetrazoles
  • Pyridines
  • Patient Admission
  • Outcome Assessment, Health Care
  • Middle Aged
  • Male
  • Length of Stay
  • Humans
  • Hospitalization
 

Citation

APA
Chicago
ICMJE
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Cotter, G., Metra, M., Davison, B. A., Senger, S., Bourge, R. C., Cleland, J. G. F., … VERITAS Investigators, . (2014). Worsening heart failure, a critical event during hospital admission for acute heart failure: results from the VERITAS study. Eur J Heart Fail, 16(12), 1362–1371. https://doi.org/10.1002/ejhf.186
Cotter, Gad, Marco Metra, Beth A. Davison, Stefanie Senger, Robert C. Bourge, John G. F. Cleland, Guillaume Jondeau, et al. “Worsening heart failure, a critical event during hospital admission for acute heart failure: results from the VERITAS study.Eur J Heart Fail 16, no. 12 (December 2014): 1362–71. https://doi.org/10.1002/ejhf.186.
Cotter G, Metra M, Davison BA, Senger S, Bourge RC, Cleland JGF, et al. Worsening heart failure, a critical event during hospital admission for acute heart failure: results from the VERITAS study. Eur J Heart Fail. 2014 Dec;16(12):1362–71.
Cotter, Gad, et al. “Worsening heart failure, a critical event during hospital admission for acute heart failure: results from the VERITAS study.Eur J Heart Fail, vol. 16, no. 12, Dec. 2014, pp. 1362–71. Pubmed, doi:10.1002/ejhf.186.
Cotter G, Metra M, Davison BA, Senger S, Bourge RC, Cleland JGF, Jondeau G, Krum H, O’Connor CM, Parker JD, Torre-Amione G, van Veldhuisen DJ, Milo O, Kobrin I, Rainisio M, McMurray JJV, Teerlink JR, VERITAS Investigators. Worsening heart failure, a critical event during hospital admission for acute heart failure: results from the VERITAS study. Eur J Heart Fail. 2014 Dec;16(12):1362–1371.
Journal cover image

Published In

Eur J Heart Fail

DOI

EISSN

1879-0844

Publication Date

December 2014

Volume

16

Issue

12

Start / End Page

1362 / 1371

Location

England

Related Subject Headings

  • Vasodilator Agents
  • Tetrazoles
  • Pyridines
  • Patient Admission
  • Outcome Assessment, Health Care
  • Middle Aged
  • Male
  • Length of Stay
  • Humans
  • Hospitalization