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Clinical Characteristics and Outcomes of De novo versus Acute Decompensated Heart Failure: Are they similar?
Session:
SESSÃO DE POSTERS 21 - IC E PROGNÓSTICO
Speaker:
Ana Rodrigo da Cunha e Costa
Congress:
CPC 2025
Topic:
D. Heart Failure
Theme:
11. Acute Heart Failure
Subtheme:
11.2 Acute Heart Failure – Epidemiology, Prognosis, Outcome
Session Type:
Cartazes
FP Number:
---
Authors:
Ana Rodrigo Costa; José Luís Ferraro; Mauro Moreira; Bruno Bragança; Rafaela G. Lopes; Inês Gomes Campos; Joel Ponte Monteiro; Liliana Reis; Aurora Andrade
Abstract
<p style="text-align:justify"><strong>Introduction:</strong> Acute heart failure (AHF) is a heterogeneous clinical syndrome and it’s the number one cause of unplanned hospitalization among individuals above 65 years old. AHF carries a high risk of morbidity and mortality. One of the existing classifications divides acute HF into de novo (DNHF) or acute decompensated chronic heart failure (ADCHF). Understanding these subgroups characteristics and outcomes may have important implications for treatment and prognosis.<br /> <strong>Objectives:</strong> The aim of this study was to evaluate clinical characteristics and long-term outcomes of patients hospitalized with AHF according to DNHF and ADCHF.<br /> <strong>Methods:</strong> Retrospective single-center cohort study of patients admitted for AHF throughout 2022, divided into two groups: DNHF and ADCHF. The primary composite outcomes were readmission for AHF, cardiovascular death and all-cause death.<br /> <strong>Results:</strong> In a total of 265 patients, 152 were included in DNHF group (74.6% male, 25.7% female) and 113 were included in ADCHF group (59.3% male, 40.7% female). Prevalence of patients with DNHF was higher under 65 years old (p=0.039). Comorbidities, such as hypertension, diabetes, dyslipidemia, atrial fibrillation and chronic coronary syndrome were more frequent in ADCHF.<br /> Conversely, this study also revealed that acute coronary syndrome was present as a precipitating factor in 27.6% of DNHF, versus 7.1% in ADCHF (<0.001). For ADCHF, laboratory findings revealed lower haemoglobin (p<0.001) and lower estimated glomerular filtration rate (p=0.009) compared to DNHF. In terms of combined endpoint, ADCHF was associated with a worse outcome (p<0.001). On the other hand, in DNHF there was a statistically significant improvement in terms of ejection fraction 1 year after discharge (p=0.005). ADCHF patients had more urgent HF visits (p=0.002), greater needs for oral diuretic up-titration (p=0.007) and more unplanned HF hospitalizations (p=0.025). There were no significant differences in cardiovascular or all-cause mortality between groups. <br /> <strong>Conclusions:</strong> Our study has revealed several clinical characteristics and outcomes between DNHF and ADCHF, with the latter demonstrating a worse prognosis. These findings highlighted the need for individualized treatment strategies for better patient care. Therefore, we need to continue researching strategies that can help prevent episodes of decompensation.</p>
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