Prognostic Clinical Phenotypes of Patients with Acute Decompensated Heart Failure.

Autor: Mohammadi T; College of Science, School of Mathematics, Statistics, and Computer Science, University of Tehran, Tehran, Iran., Tofighi S; Department of Cardiology, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran., Mohammadi B; Independent Researcher, Unit 5, No 41, 24th Eastern Alley, Azadegan Blvd., Northern Kargar St., Tehran, 1437696156, Iran. dr.bbkmmd@gmail.com., Halimi S; Department of General Medicine, Faculty of Medicine, BooAli Hospital, Islamic Azad University of Medical Sciences, Tehran, Iran., Gharebakhshi F; Department of Radiology, Imam Hossein Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Jazyk: angličtina
Zdroj: High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension [High Blood Press Cardiovasc Prev] 2023 Sep; Vol. 30 (5), pp. 457-466. Date of Electronic Publication: 2023 Sep 05.
DOI: 10.1007/s40292-023-00598-x
Abstrakt: Introduction: Acute decompensated heart failure (AHF) is a clinical syndrome with a poor prognosis.
Aim: This study was conducted to identify clusters of inpatients with acute decompensated heart failure that shared similarities in their clinical features.
Methods: We analyzed data from a cohort of patients with acute decompensated heart failure hospitalized between February 2013 and January 2017 in a Department of Cardiology. Patients were clustered using factorial analysis of mixed data. The clusters (phenotypes) were then compared using log-rank tests and profiled using a logistic model. In total, 458 patients (255; 55.7% male) with a mean (SD) age of 72.7 (11.1) years were included in the analytic dataset. The demographic, clinical, and laboratory features were included in the cluster analysis.
Results: The two clusters were significantly different in terms of time to mortality and re-hospitalization (all P < 0.001). Cluster profiling yielded an accurate discriminating model (AUC = 0.934). Typically, high-risk patients were elderly females with a lower estimated glomerular filtration rate and hemoglobin on admission compared to the low-risk phenotype. Moreover, the high-risk phenotype had a higher likelihood of diabetes type 2, transient ischemic attack/cerebrovascular accident, previous heart failure or ischemic heart disease, and a higher serum potassium concentration on admission. Patients with the high-risk phenotype were of higher New York Heart Association functional classes and more positive in their medication history.
Conclusions: There are two phenotypes among patients with decompensated heart failure, high-risk and low-risk for mortality and re-hospitalization. They can be distinguished by easy-to-measure patients' characteristics.
(© 2023. Italian Society of Hypertension.)
Databáze: MEDLINE
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