Abstract 14227: Timing Since Last Hospitalization for Heart Failure and Risks of Cardiovascular Death and Hospitalization of Heart Failure

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Introduction: Hospitalization for heart failure (hHF) is a serious event where approximately 10% die in hospital, 30-40% are readmitted within 1-year and with very poor 5-year survival rates. However, little is known about CV death or hHF risks immediately one year post discharge in a modern real-world clinical setting with access to modern HF-therapies. Hypothesis: To examine the risks of CV death and hHF in relation to timing since last hHF prior to follow-up in a prevalent HF population. Methods: Linked hospital-, prescribed drug- and cause of death registry data from Sweden was used, and hHF patients were identified by main diagnosis at an in-hospital admission. Index date was 1 st June 2018 and patients were grouped according to timing of hHF prior to index; <4, 4-8, 8-26, 26-52 and >52 weeks. Event rates were calculated per 100 patient years. Cox regressions adjusted for age, sex, ischemic heart disease, diabetes and chronic kidney disease were used to estimate risks. Results: Of 62,809 patients with a hHF; 2226 (4%), 1832 (3%), 5131 (8%), 6890 (11%) and 49,730 (74%) patients were allocated to the <4, 4-8, 8-26, 26-52 and >52 weeks groups respectively. The patient groups were similar, age 78 years, 44% women, 35% myocardial infarction but differences in CKD. Patients with the most recent hHF, <4 weeks, had the highest hHF or CV death and hHF event rates compared to the other groups, 105 and 84 events per 100 patient years, respectively. Compared with patients with the least recent hHF (>52 weeks), the risks of hHF or CV death and hHF were the highest in the group with the most recent hHF (<4 weeks); HR 5.46 (95% CI 5.07-5.89) and 7.22 (95% CI 6.60-7.89). Conclusions: In this large hHF cohort, patients with the most recent hHF timing prior to follow-up had by far the highest risks of hHF or CV death and hHF compared to patients with less recent hHF timing. This supports an urgent and prompt need for effective treatment early after hospitalization for HF, with limited acceptance for treatment inertia.