Acute heart failure after non-cardiac surgery: incidence, phenotypes, determinants and outcomes
| العنوان: | Acute heart failure after non-cardiac surgery: incidence, phenotypes, determinants and outcomes |
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| المؤلفون: | D M Gualandro, C Puelacher, M S Chew, H Andersson, G Lurati Buse, N Glarner, D Mueller, F A M Cardozo, K Burri, C Mork, D Wussler, D Bolliger, S Osswald, B Caramelli, C Mueller |
| المصدر: | European Heart Journal. 43 |
| بيانات النشر: | Oxford University Press (OUP), 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Cardiology and Cardiovascular Medicine |
| الوصف: | Background Primary acute heart failure (AHF) is an established and common cause of hospitalization. AHF may also develop secondarily, e.g. postoperatively (pAHF). Little is known about pAHF. Purpose To assess the incidence, phenotypes, determinants and outcomes of pAHF following non-cardiac surgery. Methods We prospectively included 9,164 consecutive patients at high cardiovascular risk undergoing 11,262 non-cardiac surgeries. The incidence, phenotypes, determinants and outcome of pAHF, centrally adjudicated by independent cardiologists, was determined. Logistic regression models identified the risk factors for pAHF. Cox regression analysis compared mortality and AHF readmission within 1 year in patients with and without pAHF. External validation was performed using a prospective cohort multicenter study of 1250 patients. Results The incidence of pAHF was 2.5% (95% confidence interval [CI] 2.2–2.8%). pAHF most often occurred on postoperative day 2 (median day 4). About half of pAHF (51%) occurred in patients without known HF (de novo pAHF), and 49% in patients with chronic HF. Preserved left ventricular ejection fraction (LVEF) was the dominant phenotype among de novo pAHF (72%), while reduced LVEF was dominant among pAHF in chronic HF (43%). Age, coronary artery disease, peripheral artery disease, diabetes, urgent/emergent surgery, chronic HF, atrial fibrillation, chronic obstructive pulmonary disease, anemia, and chronic myocardial injury were independent predictors of pAHF. Patients with pAHF had significantly higher all-cause mortality (44% vs. 11%, p Conclusions pAHF frequent developed following non-cardiac surgery, being de novo in about half of cases, and associated with an unacceptable high mortality. Strategies focusing on early detection and treatment of pAHF seem warranted. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Swiss National Science FoundationSwiss Heart Foundation |
| تدمد: | 1522-9645 0195-668X |
| DOI: | 10.1093/eurheartj/ehac544.2531 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::f8b9feaffe47c543a069c201dd422312 https://doi.org/10.1093/eurheartj/ehac544.2531 |
| Rights: | CLOSED |
| رقم الانضمام: | edsair.doi...........f8b9feaffe47c543a069c201dd422312 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15229645 0195668X |
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| DOI: | 10.1093/eurheartj/ehac544.2531 |