Hospitalization, death rates high for HF patients with preserved ejection fraction

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 - hospitalist and patient

Nearly one-third of patients who were hospitalized with heart failure with preserved ejection fraction died during a follow-up period of 49.5 months, according to a randomized study.

Peter E. Carson, MD, of Washington Veterans Affairs Medical Center in Washington, D.C., and colleagues published their findings in the Journal of the American College of Cardiology: Heart Failure on June 1.

They analyzed the I-PRESERVE (Irbesartan in Heart Failure and Preserved Ejection Fraction) trial, which randomized 4,128 patients from centers in 25 countries to receive irbesartan or placebo. Patients were required to be at least 60 years old and to have been hospitalized within the previous six months for heart failure. They also had New York Heart Association functional class II to IV heart failure.

During the follow-up period, 55 percent of patients were hospitalized at once. The patients who were hospitalized were older and were more likely to have ischemic causes of heart failure and a history of diabetes or MI.

Carson et al found that 5.5 percent of patients who were hospitalized died during the initial hospitalization and an additional 26.5 percent of patients died by the end of the trial. The incident mortality rate during the follow-up period was 11.1 deaths per 100 patient-years.

Further, 53.8 percent of the initial hospitalizations were due to cardiovascular causes, 43.8 percent were not due to cardiovascular causes and 2.4 percent were of unknown causes.

For patients with heart failure hospitalizations, 18 percent were readmitted within 30 days, with 73 percent due to cardiovascular causes and 48 percent due to worsening heart failure. Among patients hospitalized with heart failure, 41 percent died during the follow-up period, and the incident mortality rate was 19.3 deaths per 100 patient-years.