Journal of cardiovascular development and disease · 2026
Prognostic Factors of Acute Heart Failure: A Regional Population Registry.
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Asensio-Nogueira Juan, Rodriguez-Santamarta Miguel, Tobar-Ruíz Javier, Perdiguero-Martín Pedro Daniel, Toranzo-Nieto Inés, González-Maniega Clea, Lozano-Ibáñez Adrián, Moreno-de-Redrojo Cortes Lucía, Carrasco-Moraleja Manuel, Margalejo-Franco Álvaro, Moreno-González Andrea, Enríquez-Rodríguez Luis Eduardo, Isaza-Arana Sebastián, Roldán-Sevilla Álvaro, Hinojosa-Camargo Williams Enrique, Álvarez-Martínez Cristina, Martín-Paniagua Sara, Ruiz-Olgado María José, Perez-Rivera Jose-Angel
Аннотация
INTRODUCTION AND OBJECTIVES: Acute heart failure (AHF) is the leading cardiovascular cause of hospitalization and remains associated with high mortality and rehospitalization rates. Contemporary real-world data from cardiology departments are scarce. We aimed to identify admission characteristics associated with one-year outcomes in patients hospitalized with AHF.
METHODS: RECYLICA is a prospective, multicentre, regional registry including consecutive patients admitted with AHF to cardiology departments across 10 hospitals over a one-year period. Patients were followed for 12 months. The primary endpoint was the composite of all-cause mortality or heart failure (HF) rehospitalization.
RESULTS: A total of 602 patients were included (37.0% women; mean age 72.6 ± 12.0 years), of whom 47.4% had heart failure with reduced left ventricular ejection fraction (HFrEF). During follow-up, 83 patients (13.8%) died and 105 (17.4%) were rehospitalized because of HF. Independent predictors of the primary endpoint were elevated admission N-terminal pro-B-type natriuretic peptide (NT-proBNP), atrial fibrillation (AF), chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), previous HF, prior implantable cardioverter-defibrillator (ICD) implantation, and higher left ventricular ejection fraction (LVEF). Among patients with HFrEF, less comprehensive implementation of guideline-directed medical therapy (GDMT) at discharge was associated with significantly worse outcomes.
CONCLUSIONS: In patients hospitalized with AHF, prognosis is primarily determined by comorbidity burden, admission NT-proBNP levels, previous HF, and LVEF. Among patients with HFrEF, more comprehensive implementation of GDMT at discharge was associated with improved clinical outcomes, supporting early optimization of evidence-based therapy during hospitalization.
METHODS: RECYLICA is a prospective, multicentre, regional registry including consecutive patients admitted with AHF to cardiology departments across 10 hospitals over a one-year period. Patients were followed for 12 months. The primary endpoint was the composite of all-cause mortality or heart failure (HF) rehospitalization.
RESULTS: A total of 602 patients were included (37.0% women; mean age 72.6 ± 12.0 years), of whom 47.4% had heart failure with reduced left ventricular ejection fraction (HFrEF). During follow-up, 83 patients (13.8%) died and 105 (17.4%) were rehospitalized because of HF. Independent predictors of the primary endpoint were elevated admission N-terminal pro-B-type natriuretic peptide (NT-proBNP), atrial fibrillation (AF), chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), previous HF, prior implantable cardioverter-defibrillator (ICD) implantation, and higher left ventricular ejection fraction (LVEF). Among patients with HFrEF, less comprehensive implementation of guideline-directed medical therapy (GDMT) at discharge was associated with significantly worse outcomes.
CONCLUSIONS: In patients hospitalized with AHF, prognosis is primarily determined by comorbidity burden, admission NT-proBNP levels, previous HF, and LVEF. Among patients with HFrEF, more comprehensive implementation of GDMT at discharge was associated with improved clinical outcomes, supporting early optimization of evidence-based therapy during hospitalization.