Abstract 13041: Worsening Renal Function in Early Phase of Hospitalization Indicates Poor Prognosis of Patients With Acute Heart Failure

Abstract

Background: Worsening renal function (WRF, serum creatinine rise ≥0.3 mg/dl from admission) has been consistently shown to be among the important prognostic variables in patients admitted for acute heart failure (AHF). However, the relation between the timing of WRF and prongnosis remains unclear. Methods: We investigated 464 consecutive patients admitted for AHF between February 2015 and October 2015. After having eliminated patients with acute coronary syndrome and end stage renal disease, we enrolled 377 patients in this study sample (mean age 79.1±12.4 years). The median follow-up period was 225 (interquartile range, 88-330) days. WRF was dichotomized into early or late WRF by using the median of the occurrence day (day 3). The primary end points were all-cause death and a composite of all-cause death or rehospitalization for HF. Results: WRF occurred in 42% (n=160: early, 56%; late, 44%). The figure shows the Kaplan-Meier curves of death and death/rehospitalization for heart failure. By multivariate analysis, early phase WRF was an independent predictor of poor prognosis (see Table). Conclusion: Only early phase WRF is associated with poor prognosis. Therefore, its prevention remains an important target for treatment of AHF.