Survival rate and predictors of mortality in patients hospitalised with heart failure: a cohort study on the data of Persian registry of cardiovascular disease (PROVE)

Abstract

Objectives: Heart failure (HF) has a high rate of hospitalisation and mortality. We examined its risk factors, survival rate and the predictors.

Methods: In this prospective cohort study, demographic, clinical and treatment data of 1223 patients hospitalised with HF were extracted from the Persian Registry Of cardio Vascular diseasE (PROVE)/HF registry. Survival rate and HR and their association with other variables were assessed.

Results: 835 (68.3%) were censored, while 388 (31.7%) patients were deceased. Mean age and frequency of hypotension during hospitalisation, tachycardia, pulmonary hypertension and anaemia, hyponatremia, heart valve disease and renal disease of the deceased patients was significantly higher than censored patients (15.2vs6.1%, 51.1vs40.1%, 24.4vs16.7%, 39.0vs31.8%, respectively, p<0.05). ACE inhibitor (ACEI)/angiotensin receptor blocker (ARB) (89.8%vs82.1%, respectively) and beta blocker (BB) (81.1%vs75.5%, respectively) were higher in follow-up in the censored group (p<0.001 and 0.02, respectively). Crude Cox regression analysis identified age, tachycardia, hypotension, anaemia, pulmonary hypertension and heart valve disease as predictors of mortality (HR >1) and using ACEI/ARB and BB as predictors of life (HR <1, p<0.05). After adjustment, all variables lost their significance, except BB (HR 0.63, p=0.03) and tachycardia (HR 1.74, p=0.01) and New York Heart Association (NYHA) class IV (HR 1.90, p=0.04) became significant predictors.

Conclusions: We found a high mortality rate (31.7%). As NYHA class IV and tachycardia were significant predictors of mortality after adjustment, an effective measure can be treatment of underlying diseases, which deteriorate patients' conditions. Monitoring of medications for at-risk group, especially BB that predicts life, is important.

Keywords: heart failure; kaplan–meier estimate; risk factors; survival rate.