Abstract 19074: Clinical Predictors of Short and Long Term Mortality in Patients With Heart Failure Preserved Ejection Fraction
Introduction: A number of studies have reported predictors of adverse outcomes in patients with heart failure preserved ejection fraction (HFpEF), but few studies have reported long term outcomes and assessed the incremental value of N-terminal B-type natriuretic peptide (NT-proBNP).
Hypothesis: To determine the clinical correlates of short and long term mortality in patients hospitalized with HFpEF.
Methods: Using Stanford Translational Research Integrated Database Environment (STRIDE), we identified 1004 patients hospitalized with HFpEF and NT-proBNP > 300 pg/mL. We excluded patients with ejection fraction < 50%, valvular heart disease, end stage renal disease, advanced liver disease, pulmonary arterial hypertension and heart transplantation. After exclusion, 325 patients were included in the final analysis cohort between January 2005 and December 2014. Mortality status was determined using United States Social Security Death Index and chart review. Cox-regression analysis was performed to determine the clinical and laboratory associates on admission of mortality.
Results: The mean age of the population was 74.6 ± 15.4 years and 190 (58.5%) women. Length of hospital stay was 8.6 ± 16.2 days and median follow up of 1.10 (0.74 - 1.45) years. A total of 177 (54.6%) deaths occurred with a 1-year mortality of 30.1%. The strongest univariate correlates of mortality reported as hazard ratio per standard deviation included age [HR: 1.34 (1.13-1.58)], systolic blood pressure (SBP): [HR: 0.82 (0.69-0.99)], respiratory rate> 20 /min [HR: 1.47 (1.04-2.01)], creatinine [HR: 1.28 (1.12-1.45)], Blood urea nitrogen (BUN) [HR: 1.39 (1.24-1.58)], red blood cell distribution width [HR: 1.20 (1.07-1.34)]. On multivariate analysis, independent correlates of mortality included age (p<0.001), SBP (p=0.036), BUN (p=0.026), RDW (p=0.07) and log (NT-proBNP) with a chi-squared of 53. Systolic blood pressure, RDW and log(NT-proBNP) also emerged as independent correlates of 90-day and 1-year mortality.
Conclusions: Routinely obtained clinical and laboratory markers including NT-proBNP are complementary in predicting short and long term mortality in patients with acute HFpEF.
Author Disclosures: K.A. Boralkar: None. Y. Kobayashi: None. M. Tuzovic: None. K.J. Moneghetti: None. V.S. Pargaonkar: None. N. Ouazani: None. B. Vrtovec: None. M. Wheeler: None. D. Banerjee: None. P. Heidenreich: None. F. Haddad: None.
- © 2016 by American Heart Association, Inc.