Abstract 14215: Hyponatremia and Anemia Provide the Additional Long-Term Prognostic Information to ADHERE Risk Level in Patients Admitted for Acute Decompensated Heart Failure With Reduced or Preserved Left Ventricular Ejection Fraction
Backgrounds: The Acute Decompensated Heart Failure National Registry (AHDERE) risk levels are a validated tool to assess the risk of in-hospital mortality in patients (pts) with acute decompensated heart failure (ADHF). Hyponatremia and anemia are prognostic markers in heart failure pts, and hemoconcentration (HC) during heart failure treatment is known to be associated with improved clinical outcome in ADHF pts. The aim of this study was to investigate the additional prognostic impact of these indices on ADHERE risk levels in ADHF pts, relating to reduced or preserved left ventricular ejection fraction (HFrEF or HFpEF).
Methods and Results: We studied 303 consecutive pts admitted for ADHF and discharged alive (HFrEF[LVEF<50%];n=163, HFpEF[LVEF≥50%];n=140). ADHERE risk levels were assigned by BUN, systolic blood pressure, and serum creatinine level. During a follow-up period of 4.1±3.2 yrs, 96 patients died. In pts with HFrEF, at multivariate Cox analysis, ADHERE risk levels and hyponatremia were significantly associated with total mortality, independently of age and body mass index, although anemia and HC showed the association with the mortality at univariate analysis. HFrEF pts with hyponatremia had a significantly higher risk of the mortality in groups with both ADHERE high/intermediate and low risk levels. In pts with HFpEF, ADHERE risk levels and anemia, but not HC or hyponatremia, were also significantly associated with the mortality, independently of age and left atrial dimension index. HFpEF pts with anemia had a significantly higher risk of the mortality in a group with ADHERE low risk level but not in a group with high/intermediate risk levels.
Conclusion: Hyponatremia could provide the additional prognostic information to ADHERE risk levels in ADHF pts with HFrEF, while anemia would have the limited prognostic value in ADHF pts with HFpEF and ADHERE low risk level.
Author Disclosures: T. Yamada: None. T. Morita: None. Y. Furukawa: None. S. Tamaki: None. Y. Iwasaki: None. M. Kawasaki: None. A. Kikuchi: None. T. Kondo: None. T. Ozaki: None. Y. Sato: None. M. Seo: None. I. Ikeda: None. E. Fukuhara: None. M. Abe: None. J. Nakamura: None. M. Fukunami: None.
- © 2016 by American Heart Association, Inc.