Predictors of Mortality After Index Hospitalisation for Acute Heart Failure–Difference in HFREF and HFPEF Group

Aim: Heart failure (HF) still has very high rate of mortality. Our aim was to observe mortality after index hospitalisation for acute heart failure (AHF) and to identify its possible predictors. Methods: Survival of 222 patients after index hospitalisation for AHF was followed for next 18 months. It were collected demographic data, risk factors, laboratory test including biomarkers - admission brain natriuretic peptide (BNP), discharge BNP, procentual change of brain natriuretic peptide during hospitalisation, high sensitive troponin I, CA125 and cystatin C. Results: During 18-months follow-up 115 (51.8%) patients died and the average survival time was 3.79 (95% CI = 3.1–4.5) months. In patients who died sodium (p = 0.019), albumin (p = 0.013), procentual reduction in BNP (p < 0.001) were significantly lower, while uric acid (p < 0.001), admission BNP (p < 0.001), discharge BNP (p < 0.001), CA125 (p = 0.009) and cystatin C (p = 0.002) levels were higher. Independent predictors of 18-month mortality were arterial hypertension (HR 1.66; 95% CI = 1.1–2.5; p = 0.015), COPD (HR 1.6; 95% CI = 1.08–2.5; p = 0.021) and BMI < 25 (HR 0.81; 95% CI = 1.5–3.4; p < 0.001). Among biomarkers, independent positive predictors of risk for 18-month mortality were discharge BNP (HR 5.3; 95% CI = 1.6–17.3; p = 0.006) and serum cystatin C (HR 4.2; 95% CI = 1.3–13.5; p = 0.015).