scholarly journals 572 Different renal function patterns in acute heart failure patients

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Gaetano Ruocco ◽  
Mauro Feola ◽  
Lorenzo Luschi ◽  
Angelica Brazzi ◽  
Nicolo Ghionzoli ◽  
...  
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Acute Heart Failure ◽  
Univariate Analysis ◽  
Multivariable Analysis ◽  
Permanent Improvement ◽  
Transient Improvement ◽  
Causes Of Mortality ◽  
Post Hoc

Abstract Aims The role of worsening renal function during acute heart failure (AHF) hospitalization is still debated. Very few studies have extensively evaluated the renal function (RF) trend during hospitalization by repetitive measurements. The aim of this study is to investigate the prognostic relevance of different RF trajectories together with the congestion status in hospitalized patients. Methods and results This is a post hoc analysis of a multi-centres study including 467 patients admitted with AHF who were screened for the Diur-AHF Trial. We recognized five main RF trajectories based on serum creatinine and estimated glomerular filtration rate (eGFR) behaviour: according to the RF curve our sample was divided into 1-stable (S), 2-transient improvement (TI), 3-permanent improvement (PI), 4-transient worsening (TW), and 5-persistent worsening (PW). The primary outcome was the combined endpoint of 180 days including all causes of mortality and re-hospitalization. We recruited 467 subjects with a mean congestion score of 3.5 ± 1.08 and a median creatinine value of 1.28 (1.00–1.70) mg/dl, eGFR 50 (37–65) ml/min/m2, and NTpro BNP 7000 (4200–11 700) pg/ml. A univariate analysis of the RF pattern demonstrated that TI and PW patterns were significantly related to poor prognosis [HR: 2.71 (1.81–4.05); P < 0.001; HR: 1.68 (1.15–2.45); P = 0.007, respectively]. Conversely, the TW pattern showed a significantly protective effect on outcome [HR: 0.34 (0.19–0.60); P < 0.001]. Persistence of congestion and BNP reduction ≥ 30% were significantly related to clinical outcome at univariate analysis [HR: 2.41 (1.81–3.21); P < 0.001 and HR: 0.47 (0.35–0.67); P < 0.001]. A multivariable analysis confirmed the independently prognostic role of TI, PW patterns, persistence of congestion and reduced BNP decrease at discharge. Conclusions Various RF patterns during AHF hospitalization are associated with different risk(s). PW and TI appear to be the two trajectories related to worse outcome. Current findings confirm the importance of RF evaluation during and after hospitalization.

scholarly journals 573 Different renal function patterns in acute heart failure patients

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Gaetano Ruocco ◽  
Mauro Feola ◽  
Lorenzo Luschi ◽  
Angelica Brazzi ◽  
Nicolo Ghionzoli ◽  
...  
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Acute Heart Failure ◽  
Univariate Analysis ◽  
Multivariable Analysis ◽  
Permanent Improvement ◽  
Transient Improvement ◽  
Causes Of Mortality ◽  
Post Hoc

Abstract Aims The role of worsening renal function during acute heart failure (AHF) hospitalization is still debated. Very few studies have extensively evaluated the renal function (RF) trend during hospitalization by repetitive measurements. The aim of this study is to investigate the prognostic relevance of different RF trajectories together with the congestion status in hospitalized patients. Methods and results This is a post hoc analysis of a multi-centres study including 467 patients admitted with AHF who were screened for the Diur-AHF Trial. We recognized five main RF trajectories based on serum creatinine and estimated glomerular filtration rate (eGFR) behaviour: according to the RF curve our sample was divided into 1-stable (S), 2-transient improvement (TI), 3-permanent improvement (PI), 4-transient worsening (TW), and 5-persistent worsening (PW). The primary outcome was the combined endpoint of 180 days including all causes of mortality and re-hospitalization. We recruited 467 subjects with a mean congestion score of 3.5 ± 1.08 and a median creatinine value of 1.28 (1.00–1.70) mg/dl, eGFR 50 (37–65) ml/min/m2, and NTpro BNP 7000 (4200–11 700) pg/ml. A univariate analysis of the RF pattern demonstrated that TI and PW patterns were significantly related to poor prognosis [HR: 2.71 (1.81–4.05); P < 0.001; HR: 1.68 (1.15–2.45); P = 0.007, respectively]. Conversely, the TW pattern showed a significantly protective effect on outcome [HR: 0.34 (0.19–0.60); P < 0.001]. Persistence of congestion and BNP reduction ≥ 30% were significantly related to clinical outcome at univariate analysis [HR: 2.41 (1.81–3.21); P < 0.001 and HR: 0.47 (0.35–0.67); P < 0.001]. A multivariable analysis confirmed the independently prognostic role of TI, PW patterns, persistence of congestion, and reduced BNP decrease at discharge. Conclusions Various RF patterns during AHF hospitalization are associated with different risk(s). PW and TI appear to be the two trajectories related to worse outcome. Current findings confirm the importance of RF evaluation during and after hospitalization.

scholarly journals The prognostic role of different renal function phenotypes in patients with acute heart failure

2019 ◽  
Vol 276 ◽  
pp. 198-203 ◽  
Author(s):  
Alberto Palazzuoli ◽  
Gaetano Ruocco ◽  
Pierpaolo Pellicori ◽  
Eufemia Incampo ◽  
Cristina Di Tommaso ◽  
...  
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Acute Heart Failure ◽  
Prognostic Role

Role of Worsening Renal Function in Patients Hospitalised for Acute Heart Failure

2007 ◽  
Vol 13 (6) ◽  
pp. S168
Author(s):  
Benedetta Fontanella ◽  
Marco Metra ◽  
Savina Nodari ◽  
Giovanni Parrinello ◽  
Tania Bordonali ◽  
...  
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Acute Heart Failure ◽  
Worsening Renal Function

scholarly journals Clinical characteristics and outcomes of patients admitted with acute heart failure: insights from a single-center heart failure registry in South India

2021 ◽  
Vol 73 (1) ◽  
Author(s):  
Aashiq Ahamed Shukkoor ◽  
Nimmy Elizabeth George ◽  
Shanmugasundaram Radhakrishnan ◽  
Sivakumar Velusamy ◽  
Rajendiran Gopalan ◽  
...  
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Hospital Mortality ◽  
Hospital Stay ◽  
Acute Heart Failure ◽  
South India ◽  
Univariate Analysis ◽  
North India ◽  
Study Cohort ◽  
Hospital Outcomes

Abstract Background The epidemiology of HF in India is largely unexplored. Current resources are based on a few hospital-based and a community-based registry from North India. Thus, we present the data from a single hospital-based registry in South India. Patients admitted with acute heart failure over a period of 1 year were enrolled in the registry and were characterized based on their ejection fraction (EF) measured by echocardiogram. The clinical profile of the patients was assessed, including their in-hospital outcomes. One-way ANOVA and univariate analysis were performed for comparison between three EF-based groups and for the assessment of in-hospital outcomes. Results A total of 449 patients were enrolled in the registry, of which 296, 90, and 63 patients were categorized as, HFrEF, HFmrEF, and HFpEF, respectively. The prevalence of HFrEF was higher (65.99%). The mean age (SD) of the study cohort was 59.9±13.3. The majority of the patients presented with acute denovo HF (67%) and were more likely to be males (65.9%). The majority of patients presented with warm and wet clinical phenotype (86.4%). In hospital mortality was higher in HFmrEF (3.3%). Conclusion Patients with HFrEF had high adherence to guideline-directed medical therapy (GDMT). HFrEF patients were also likely to have longer hospital stay along with a worsening of renal function. The in-hospital mortality was comparable between the EF-based groups. Additionally, the association of clinical phenotypes with outcome highlighted that patients in warm and wet phenotype had a longer length of hospital stay, whereas the mortality and worsening renal function rates were found to be significantly higher in the cold and wet group.

588 The prognostic role of anemia in acute heart failure. Data from the Italian survey on acute heart failure

2006 ◽  
Vol 5 (1) ◽  
pp. 134-134
Author(s):  
L SCELSI ◽  
L TAVAZZI ◽  
A MAGGIONI ◽  
D LUCCI ◽  
G CACCIATORE ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Prognostic Role ◽  
Failure Data ◽  
Italian Survey
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