Differences in clinical characteristics and mortality of de novo acute heart failure and acutely decompensated chronic heart failure: A prospective cohort study

Abstract

Background: Acute heart failure carries a high risk of mortality. Understanding the characteristics and outcomes of acute heart failure subgroups may have important implications for clinical risk stratification. Objective: We examined the clinical characteristics and rates of the 12-month all-cause mortality in a cohort of patients hospitalized with acute heart failure according to heart failure duration new-onset or de novo acute heart failure and acutely decompensated chronic heart failure (ADCHF). Methods and Materials: The cohort study, with a 12-month followup, was conducted at Nhan Dan Gia Dinh Hospital in Vietnam from February 2022 to October 2023. Results: Among 316 patients with acute heart failure, 159 patients (50%) were admitted presenting de novo AHF, while the remaining 157 patients (50%) exhibited ADCHF. Patients with ADCHF were characterized by a higher proportion of elders, comorbidities including chronic kidney disease and atrial fibrillation, and a larger left atrial diameter than those with de novo acute heart failure. The rates of mortality in patients with ADCHF were 1.69 times more than in patients with de novo acute heart failure (the hazard ratio (HR): 1.69 (The 95% confidence interval (CI 95%): 1.10 - 2.60, p = 0.016). However, patients with ADCHF had not an independent predictor of 12-month mortality after adjusting factors in multivariable Cox regression models, including age, chronic pulmonary disease, diabetes mellitus, coronary heart disease, atrial fibrillation, sodium, hemoglobin, N-terminal prohormone BNP (NT-proBNP). Conclusions: Among patients hospitalized with acute heart failure, acutely decompensated chronic heart failure was associated with poorer outcomes.