High 5-year mortality in patients admitted with heart failure regardless of ejection fraction


Background: Heart failure with preserved EF is a common cause of inpatient admission and previously was thought to carry a better prognosis than heart failure with reduced EF. Recent analysis using data from Get With the Guidelines–Heart Failure (GWTG-HF) registry has shown similarly poor survival rates at 30 days and 1 year when compared with heart failure with reduced EF.

Study design: Multicenter retrospective cohort study.

Setting: 276 hospitals in the GWTG-HF registry during 2005-2009, with 5 years of follow-up through 2014.

Synopsis: A total 39,982 patients who were admitted for heart failure during 2005-2009 were included in the study with stratification into three groups based on ejection fraction; 18,398 (46%) with heart failure with reduced EF; 2,385 (8.2%) with heart failure with borderline EF; and 18,299 (46%) with heart failure with preserved EF. The 5-year mortality rate for the entire cohort was 75.4% with similar mortality rates for patient with preserved EF (75.3%), compared with those with reduced EF (75.7%).

Bottom line: Among patients hospitalized with heart failure, irrespective of their ejection fraction, the 5-year survival rates were equally dismal. Hospitalists may wish to use this information in goals of care discussions.

Citation: Shah KS et al. Heart failure with preserved, borderline, and reduced ejection fraction: 5-year outcomes. J Am Coll Cardiol. 2017 Oct 31. doi: 10.1016/j.jacc.2017.08.074.

Dr. Miriam Gomez-Sanchez, a hospitalist at the University of Virginia Medical Center

Dr. Miriam Gomez-Sanchez

Dr. Gomez-Sanchez is a hospitalist at the University of Virginia Medical Center.

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