Open AccessPredictive value of heart failure with reduced versus preserved ejection fraction for outcome in pulmonary embolism
Author(s) -
Obradovic Slobodan,
Dzudovic Boris,
Subotic Bojana,
Matijasevic Jovan,
Mladenovic Zorica,
Bokan Aleksandar,
Trobok Jadranka,
Pekovic Sandra,
SalingerMartinovic Sonja,
Jovanovic Ljiljana,
Kos Ljiljana,
KovacevicPreradovic Tamara,
Nikolic Maja,
Miloradovic Vladimir,
KovacevicKuzmanovic Ana,
Zec Nenad,
MarkovicNikolic Natasa,
Srdanovic Ilija,
Gluvic Zoran,
Kafedzic Srdjan,
Pancevacki Sasa,
Neskovic Aleksandar,
Konstantinides Stavros
Publication year - 2020
Publication title -
esc heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.787
H-Index - 25
ISSN - 2055-5822
DOI - 10.1002/ehf2.13015
Subject(s) - medicine , cardiology , heart failure , ejection fraction , hazard ratio , atrial fibrillation , heart failure with preserved ejection fraction , pulmonary embolism , pulmonary hypertension , confidence interval
Abstract Aims This study aimed to investigate whether the risk of short‐term mortality is different in pulmonary embolism (PE) patients who have heart failure with reduced ejection fraction (HFrEF) as compared with those with heart failure with preserved ejection fraction (HFpEF). Methods and results Predictive value of HFrEF or HFpEF for 7‐day (intrahospital) and 30‐day all‐cause mortality was determined in the cohort of 1055 out of 1201 consecutive acute PE patients from the Serbian multicentre PE registry. Patients were classified into either HFrEF or HFpEF group, according to guideline‐proposed criteria. A 7‐day (intrahospital) and 30‐day all‐cause mortality was 18.5% vs. 7.3% vs. 4.5% ( P < 0.001) and 22.2% vs. 16.3% vs. 7.9% ( P < 0.001) for patients with the history of HFrEF, HFpEF, and without HF, respectively. Multivariable analysis adjusted to age, gender, history of chronic obstructive pulmonary disease, diabetes mellitus, arterial hypertension, presence of atrial fibrillation, and mortality risk assessment at admission has shown that only HFrEF, but not HFpEF, was an independent predictor for 7‐day mortality (hazard ratio 2.22, 95% confidence interval 1.25‐4,38.41, P = 0.021) and neither HFrEF or HFpEF was an independent predictor for 30‐day mortality. Among various admission parameters associated to PE outcome, only systolic pressure in HFrEF patients ( P < 0.001), heart rate ( P = 0.01), and right ventricle systolic pressure ( P = 0.039) in HFpEF patients were significantly different in patients who died compared with those who survived at 7 days. Conclusions Our study has shown that the presence of previous history of HFrEF, but not HFpEF, in acute PE is an independent risk factor for mortality at 7 days.