Prognosis and risk stratification in patients with decompensated heart failure receiving inotropic therapy
| Autor: | C B Terhoch, Silvia Moreira Ayub-Ferreira, Fernando Friões, Vera Maria Cury Salemi, Clara Gomes, Paulo Roberto Chizzola, Germano Emilio Conceição-Souza, Mucio Tavares de Oliveira, Victor Sarli Issa, Edimar Alcides Bocchi, Silvia G. Lage |
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| Rok vydání: | 2018 |
| Předmět: |
Chagas disease
Inotrope medicine.medical_specialty Ejection fraction business.industry heart failure decompensated heart failure inotropes Dilated cardiomyopathy medicine.disease Internal medicine Heart failure Circulatory system medicine Cardiology In patient prognosis Cardiology and Cardiovascular Medicine Prospective cohort study business Heart Failure and Cardiomyopathies risk |
| Zdroj: | Open Heart |
| ISSN: | 2053-3624 |
| Popis: | ObjectivesThe prognostic significance of transient use of inotropes has been sufficiently studied in recent heart failure (HF) populations. We hypothesised that risk stratification in these patients could contribute to patient selection for advanced therapies.MethodsWe analysed a prospective cohort of adult patients admitted with decompensated HF and ejection fraction (left ventricular ejection fraction (LVEF)) less than 50%. We explored the outcomes of patients requiring inotropic therapy during hospital admission and after discharge.ResultsThe study included 737 patients, (64.0% male), with a median age of 58 years (IQR 48–66 years). Main aetiologies were dilated cardiomyopathy in 273 (37.0%) patients, ischaemic heart disease in 195 (26.5%) patients and Chagas disease in 163 (22.1%) patients. Median LVEF was 26 % (IQR 22%–35%). Inotropes were used in 518 (70.3%) patients. In 431 (83.2%) patients, a single inotrope was administered. Inotropic therapy was associated with higher risk of in-hospital death/urgent heart transplant (OR=10.628, 95% CI 5.055 to 22.344, pConclusionsInotropic drugs are still widely used in patients with advanced decompensated HF and are associated with a worse in-hospital prognosis. In contrast with previous results, intermittent use of inotropes during hospitalisation did not determine a worse prognosis at 180-day follow-up. These data may add to prognostic evaluation in patients with advanced HF in centres where mechanical circulatory support is not broadly available. |
| Databáze: | OpenAIRE |
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