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Prognostic Significance of Atrial Fibrillation in Acute Heart Failure Admissions: The New Zealand Heart Failure Registry
Abstracts Abstracts
Conclusion: Results show that overall, only 61% of pacing indications were correctly identified by the general physicians. This suggests that some educations for general physicians may be beneficial given the frequency they encounter these patients.
509
Prevalence of Hyponatraemia in Acute Heart Failure Admissions and Short Term Outcomes: The New Zealand Heart Failure Registry V. Pera 1,∗ , R. Troughton 2 , M. Lund 3 , R. Doughty 4 , G. Devlin 1 , on behalf of the NZHFR Investigators 1 Waikato
http://dx.doi.org/10.1016/j.hlc.2012.03.081
Hospital, Hamilton, New Zealand Hospital, Christchurch, New Zealand 3 Middlemore Hospital, Auckland, New Zealand 4 Auckland City Hospital, Auckland, New Zealand 2 Christchurch
Prognostic Significance of Atrial Fibrillation in Acute Heart Failure Admissions: The New Zealand Heart Failure Registry V. Pera 1,∗ , R. Troughton 2 , M. Lund 3 , R. Doughty 4 , G. Devlin 1 , on behalf of the NZHFR Investigators 1 Waikato
Hospital, Hamilton, New Zealand Hospital, Christchurch, New Zealand 3 Middlemore Hospital, Auckland, New Zealand 4 Auckland City Hospital, Auckland, New Zealand 2 Christchurch
Background: There is limited data available regarding the prognostic implication of atrial fibrillation (AF) in heart failure patients with preserved systolic function (HFPSF). We report our experience with the New Zealand Heart Failure Registry (NZHFR). Methods: NZHFR is a national, prospective, observational web-based registry. We compared the short-term outcomes of patients in AF vs. Sinus rhythm (SR) in hospitalised patients with HFPSF and those with impaired systolic function (HFISF). Results: A total of 1609 patients were enrolled, between July 2006 and February 2012 and 1224 with echocardiograms were included in this analysis with 90-day follow up data available in 92% (1126/1224). Atrial fibrillation was present at baseline in 461 (51%) patients with HFISF (LVEF < 50%) and in 199 (62%) patients with HFPSF (LVEF > 50%). BNP levels were similar in both AF and SR patients (mean BNP 897 vs 839, P = 0.47 in HFISF and 677 vs 662, P = 0.89 in HFPSF). Outcomes are shown in the table. Physician grade
Number
% correct results
Senior medical officer Advanced trainee/MOSS General medical trainee House officer Other (medical student, scientists)
10 2 9 8 9
67 77 59 56 59
Total
38
61
Conclusion: AF is associated with higher 90-day mortality compared to SR in both HFISF and HFPSF, but similar in-hospital mortality and readmission rates. http://dx.doi.org/10.1016/j.hlc.2012.03.082
Background: Hyponatraemia is the most common electrolyte abnormality in hospitalised heart failure patients. We report the prevalence and prognostic significance of hyponatraemia in New Zealand Heart Failure Registry (NZHFR). Methods: NZHFR is a national, prospective, observational web-based registry. We compared the short-term outcomes of hospitalised heart failure patients with hyponatraemia (p-sodium < 136 mmol/L) vs. normonatraemia (p-sodium > 136 mmol/L). Results: A total of 1609 patients were enrolled, between July 2006 and February 2012 with 90-day follow up data available in 92% (1478/1609). 375 patients (23%) had hyponatraemia (mean p-sodium 131 ± 4) on admission compared to 1234 patients (77%) with normal sodium (mean p-sodium 140 ± 3). Patients with hyponatraemia were older (mean age 72.7 ± 15 vs. 69 ± 15, P = < 0.0001) with higher BNP values (median BNP 700 vs. 508, P = 0.0002). Discharge medication and outcomes are shown in the table. Discharge medications
Hyponatraemia (p-sodium < 136 mmol/L)
Normonatraemia (p-sodium > 136 mmol/L)
Diuretics
341/348 (99%) 148 ± 150
1158/1196 (97%) 110 ± 101
277/348 (80%) 256/348 (74%) 138/348 (40%)
980/1196 (82%) 945/1196 (79%) 360/1196 (30%)
Mean frusemide equivalent dose (mg) ACE-I/ARBs Beta blockers Aldosterone antagonists
P value
0.36 <0.0001* 0.35 0.034* 0.001*
Outcomes
Hyponatraemia
Normonatraemia
P value
Length of stay (mean ± SD) (days) In-hospital mortality Mortality at 90-day F/U Readmission at 90-day F/U
10 ± 9 27/375 (5%) 93/349 (25%) 73/349 (20%)
8±7 38/1234 (3%) 134/1129 (11%) 140/1129 (11%)
<0.0001* 0.0008* <0.0001* <0.0001*
Conclusion: Hyponatraemia in heart failure admissions is associated with prolonged hospitalisation, higher inhospital and 90-day mortality and readmission rates. http://dx.doi.org/10.1016/j.hlc.2012.03.083
ABSTRACTS
Heart, Lung and Circulation 2012;21:480–526
Conclusion: Results show that overall, only 61% of pacing indications were correctly identified by the general physicians. This suggests that some educations for general physicians may be beneficial given the frequency they encounter these patients.
509
Prevalence of Hyponatraemia in Acute Heart Failure Admissions and Short Term Outcomes: The New Zealand Heart Failure Registry V. Pera 1,∗ , R. Troughton 2 , M. Lund 3 , R. Doughty 4 , G. Devlin 1 , on behalf of the NZHFR Investigators 1 Waikato
http://dx.doi.org/10.1016/j.hlc.2012.03.081
Hospital, Hamilton, New Zealand Hospital, Christchurch, New Zealand 3 Middlemore Hospital, Auckland, New Zealand 4 Auckland City Hospital, Auckland, New Zealand 2 Christchurch
Prognostic Significance of Atrial Fibrillation in Acute Heart Failure Admissions: The New Zealand Heart Failure Registry V. Pera 1,∗ , R. Troughton 2 , M. Lund 3 , R. Doughty 4 , G. Devlin 1 , on behalf of the NZHFR Investigators 1 Waikato
Hospital, Hamilton, New Zealand Hospital, Christchurch, New Zealand 3 Middlemore Hospital, Auckland, New Zealand 4 Auckland City Hospital, Auckland, New Zealand 2 Christchurch
Background: There is limited data available regarding the prognostic implication of atrial fibrillation (AF) in heart failure patients with preserved systolic function (HFPSF). We report our experience with the New Zealand Heart Failure Registry (NZHFR). Methods: NZHFR is a national, prospective, observational web-based registry. We compared the short-term outcomes of patients in AF vs. Sinus rhythm (SR) in hospitalised patients with HFPSF and those with impaired systolic function (HFISF). Results: A total of 1609 patients were enrolled, between July 2006 and February 2012 and 1224 with echocardiograms were included in this analysis with 90-day follow up data available in 92% (1126/1224). Atrial fibrillation was present at baseline in 461 (51%) patients with HFISF (LVEF < 50%) and in 199 (62%) patients with HFPSF (LVEF > 50%). BNP levels were similar in both AF and SR patients (mean BNP 897 vs 839, P = 0.47 in HFISF and 677 vs 662, P = 0.89 in HFPSF). Outcomes are shown in the table. Physician grade
Number
% correct results
Senior medical officer Advanced trainee/MOSS General medical trainee House officer Other (medical student, scientists)
10 2 9 8 9
67 77 59 56 59
Total
38
61
Conclusion: AF is associated with higher 90-day mortality compared to SR in both HFISF and HFPSF, but similar in-hospital mortality and readmission rates. http://dx.doi.org/10.1016/j.hlc.2012.03.082
Background: Hyponatraemia is the most common electrolyte abnormality in hospitalised heart failure patients. We report the prevalence and prognostic significance of hyponatraemia in New Zealand Heart Failure Registry (NZHFR). Methods: NZHFR is a national, prospective, observational web-based registry. We compared the short-term outcomes of hospitalised heart failure patients with hyponatraemia (p-sodium < 136 mmol/L) vs. normonatraemia (p-sodium > 136 mmol/L). Results: A total of 1609 patients were enrolled, between July 2006 and February 2012 with 90-day follow up data available in 92% (1478/1609). 375 patients (23%) had hyponatraemia (mean p-sodium 131 ± 4) on admission compared to 1234 patients (77%) with normal sodium (mean p-sodium 140 ± 3). Patients with hyponatraemia were older (mean age 72.7 ± 15 vs. 69 ± 15, P = < 0.0001) with higher BNP values (median BNP 700 vs. 508, P = 0.0002). Discharge medication and outcomes are shown in the table. Discharge medications
Hyponatraemia (p-sodium < 136 mmol/L)
Normonatraemia (p-sodium > 136 mmol/L)
Diuretics
341/348 (99%) 148 ± 150
1158/1196 (97%) 110 ± 101
277/348 (80%) 256/348 (74%) 138/348 (40%)
980/1196 (82%) 945/1196 (79%) 360/1196 (30%)
Mean frusemide equivalent dose (mg) ACE-I/ARBs Beta blockers Aldosterone antagonists
P value
0.36 <0.0001* 0.35 0.034* 0.001*
Outcomes
Hyponatraemia
Normonatraemia
P value
Length of stay (mean ± SD) (days) In-hospital mortality Mortality at 90-day F/U Readmission at 90-day F/U
10 ± 9 27/375 (5%) 93/349 (25%) 73/349 (20%)
8±7 38/1234 (3%) 134/1129 (11%) 140/1129 (11%)
<0.0001* 0.0008* <0.0001* <0.0001*
Conclusion: Hyponatraemia in heart failure admissions is associated with prolonged hospitalisation, higher inhospital and 90-day mortality and readmission rates. http://dx.doi.org/10.1016/j.hlc.2012.03.083
ABSTRACTS
Heart, Lung and Circulation 2012;21:480–526