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Survival rate and predictors of mortality in patients hospitalised with heart failure: a cohort study on the data of Persian registry of cardiovascular disease (PROVE)
  1. Mahshid Givi1,
  2. Davood Shafie1,
  3. Fatemeh Nouri2,3,
  4. Mohammad Garakyaraghi1,
  5. Ghasem Yadegarfar2,3,
  6. Nizal Sarrafzadegan2,4
  1. 1Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
  4. 4Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
  1. Correspondence to Dr Ghasem Yadegarfar, Isfahan Cardiovascular Institute, Isfahan University of Medical Sciences, Isfahan 814651148, Iran; yadegarfar{at}gmail.com

Abstract

Objectives Heart failure (HF) has a high rate of hospitalisation and mortality. We examined its risk factors, survival rate and the predictors.

Methods In this prospective cohort study, demographic, clinical and treatment data of 1223 patients hospitalised with HF were extracted from the Persian Registry Of cardio Vascular diseasE (PROVE)/HF registry. Survival rate and HR and their association with other variables were assessed.

Results 835 (68.3%) were censored, while 388 (31.7%) patients were deceased. Mean age and frequency of hypotension during hospitalisation, tachycardia, pulmonary hypertension and anaemia, hyponatremia, heart valve disease and renal disease of the deceased patients was significantly higher than censored patients (15.2vs6.1%, 51.1vs40.1%, 24.4vs16.7%, 39.0vs31.8%, respectively, p<0.05). ACE inhibitor (ACEI)/angiotensin receptor blocker (ARB) (89.8%vs82.1%, respectively) and beta blocker (BB) (81.1%vs75.5%, respectively) were higher in follow–up in the censored group (p<0.001 and 0.02, respectively). Crude Cox regression analysis identified age, tachycardia, hypotension, anaemia, pulmonary hypertension and heart valve disease as predictors of mortality (HR >1) and using ACEI/ARB and BB as predictors of life (HR <1, p<0.05). After adjustment, all variables lost their significance, except BB (HR 0.63, p=0.03) and tachycardia (HR 1.74, p=0.01) and New York Heart Association (NYHA) class IV (HR 1.90, p=0.04) became significant predictors.

Conclusions We found a high mortality rate (31.7%). As NYHA class IV and tachycardia were significant predictors of mortality after adjustment, an effective measure can be treatment of underlying diseases, which deteriorate patients’ conditions. Monitoring of medications for at–risk group, especially BB that predicts life, is important.

  • heart failure
  • survival rate
  • risk factors
  • kaplan–meier estimate

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Footnotes

  • Contributors All authors except FN contributed to the development of the design of Persian Registry of Cardiovascular Disease/Heart Failure (PROVE/HF) and the cohort. Baseline and follow up questionnaire were designed by MG, DS, MGY, NZ and validated by GY. Recruitment data were collected by MG and DS. Validity of follow-up measurements approved by DS and collected by MG. FN managed and checked the collected data. Data analyses were led by GY and performed by FN. The first draft of the manuscript was written by MG. MG, DS, MGY, NZ and GY contributed to critical revisions of the paper. Funding for cohort study was secured by NZ and MGY. The final manuscript was read and approved by all authors.

  • Funding This work was supported by the undersecretary of Research and Technology of the Ministry of Health and Medical Education, Isfahan Cardiovascular Research Institute, Espadan Association of Research of Heart Health Research and the Iranian Network of Cardiovascular Research.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Ethics Committee of Isfahan University of Medical Sciences (project registry code: 394422).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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