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PROGNOSTIC VALUE OF HEMOCONCENTRATION IN ACUTE DECOMPENSATED HEART FAILURE WITH PRESERVED AND REDUCED EJECTION FRACTION: DATA FROM THE KOREAN HEART FAILURE (KORHF) REGISTRY
A1038 JACC March 17, 2015 Volume 65, Issue 10S
Heart Failure and Cardiomyopathies Prognostic Value of Hemoconcentration in Acute Decompensated Heart Failure with Preserved and Reduced Ejection Fraction: Data from the Korean Heart Failure (KorHF) Registry Poster Contributions Poster Hall B1 Monday, March 16, 2015, 9:45 a.m.-10:30 a.m. Session Title: Moving Towards Better Management of Heart Failure Abstract Category: 14. Heart Failure and Cardiomyopathies: Clinical Presentation Number: 1252-208 Authors: Jaewon Oh, Seok-Min Kang, Namki Hong, Jong-Chan Youn, Sungha Park, Sang-Hak Lee, Donghoon Choi, Severance Cardiovascular Hospital Yonsei University College of Medicine, Seoul, South Korea
Background: Hemoconcentration (HC) during hospitalization was known to be related with improved clinical outcomes in patients (pts) with acute decompensated heart failure (ADHF). However, there have not been any reports about the different impact of HC in the prediction of clinical outcomes in HF with preserved (HFPEF) and reduced ejection fraction (HFREF) until now.
Methods: We analyzed 2,357 hospitalized ADHF pts (1,169 males, 68 ± 14 years old, 38.1% ischemic origin, left ventricular ejection fraction 38.5 ± 15.7%) from Korean Heart Failure (KorHF) Registry. We defined HCT (n=1,016, 43.1%) as an increased hemoglobin level from admission to discharge and HEPEF (left ventricular ejection fraction, LVEF ≥ 45%, n=760) and HFREF (LVEF < 45%, n=1,597). Cardiovascular (CV) event was a composite clinical endpoint of all-cause mortality and HF rehospitalization. During follow-up period (median 361, IQR 79-837 days), CV event occurred in 917 ADHF pts (38.9%) including 435 (18.5%) all-cause mortality.
Results: The pts with HFPEF were older and had higher body mass index, glomerular filtration rate and lower glucose, N-terminal pro B-type natriuretic peptide levels. The hemoglobin levels at admission (12.0±2.3 vs. 12.6±2.3 gm/dL, p<0.001) and discharge (11.7±2.0 vs. 12.3±2.3 gm/dL, p<0.001) were significantly lower in HFPEF pts rather than HFREF pts. However, the change of hemoglobin from admission to discharge (-0.3±1.7 vs -0.3±1.8 for HFREF, p=0.676) and the prevalence of HC (41.2% vs 44.0% for HFREF, p=0.197) were not significantly different between two groups. The survival analysis showed that HC was related with lower CV event in pts with HFREF (33.4% vs 43.4%, log-rank p<0.001) but not in those with HFPEF (38.3% vs 38.9%, log-rank p=0.984, p for interaction<0.001). Conclusion: Our study demonstrated that HC was related to improved clinical outcomes in hospitalized ADHF pts with HFREF, not in those with HFPEF. Therefore, this unanticipated finding about clinical implication of HC may provide a new insight to the decongestive strategy of ADHF in terms of LVEF.
Heart Failure and Cardiomyopathies Prognostic Value of Hemoconcentration in Acute Decompensated Heart Failure with Preserved and Reduced Ejection Fraction: Data from the Korean Heart Failure (KorHF) Registry Poster Contributions Poster Hall B1 Monday, March 16, 2015, 9:45 a.m.-10:30 a.m. Session Title: Moving Towards Better Management of Heart Failure Abstract Category: 14. Heart Failure and Cardiomyopathies: Clinical Presentation Number: 1252-208 Authors: Jaewon Oh, Seok-Min Kang, Namki Hong, Jong-Chan Youn, Sungha Park, Sang-Hak Lee, Donghoon Choi, Severance Cardiovascular Hospital Yonsei University College of Medicine, Seoul, South Korea
Background: Hemoconcentration (HC) during hospitalization was known to be related with improved clinical outcomes in patients (pts) with acute decompensated heart failure (ADHF). However, there have not been any reports about the different impact of HC in the prediction of clinical outcomes in HF with preserved (HFPEF) and reduced ejection fraction (HFREF) until now.
Methods: We analyzed 2,357 hospitalized ADHF pts (1,169 males, 68 ± 14 years old, 38.1% ischemic origin, left ventricular ejection fraction 38.5 ± 15.7%) from Korean Heart Failure (KorHF) Registry. We defined HCT (n=1,016, 43.1%) as an increased hemoglobin level from admission to discharge and HEPEF (left ventricular ejection fraction, LVEF ≥ 45%, n=760) and HFREF (LVEF < 45%, n=1,597). Cardiovascular (CV) event was a composite clinical endpoint of all-cause mortality and HF rehospitalization. During follow-up period (median 361, IQR 79-837 days), CV event occurred in 917 ADHF pts (38.9%) including 435 (18.5%) all-cause mortality.
Results: The pts with HFPEF were older and had higher body mass index, glomerular filtration rate and lower glucose, N-terminal pro B-type natriuretic peptide levels. The hemoglobin levels at admission (12.0±2.3 vs. 12.6±2.3 gm/dL, p<0.001) and discharge (11.7±2.0 vs. 12.3±2.3 gm/dL, p<0.001) were significantly lower in HFPEF pts rather than HFREF pts. However, the change of hemoglobin from admission to discharge (-0.3±1.7 vs -0.3±1.8 for HFREF, p=0.676) and the prevalence of HC (41.2% vs 44.0% for HFREF, p=0.197) were not significantly different between two groups. The survival analysis showed that HC was related with lower CV event in pts with HFREF (33.4% vs 43.4%, log-rank p<0.001) but not in those with HFPEF (38.3% vs 38.9%, log-rank p=0.984, p for interaction<0.001). Conclusion: Our study demonstrated that HC was related to improved clinical outcomes in hospitalized ADHF pts with HFREF, not in those with HFPEF. Therefore, this unanticipated finding about clinical implication of HC may provide a new insight to the decongestive strategy of ADHF in terms of LVEF.