Predicting the in-Hospital Outcome in Acute Heart Failure: Role of Laboratory Tests

Document Type : Original Article

Authors

1 Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran.

2 Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.

3 Department of Genetics, Faculty of Advanced Medical Technologies, Golestan University of Medical Sciences, Gorgan, IR Iran.

Abstract

Background: Despite impressive advances in therapeutics in the last years, acute heart failure (AHF) remains a major cause of cardiovascular morbidity and mortality. Additionally, worsening renal failure (WRF) during hospitalization has a significant effect on rehospitalization and mortality in such patients. In this study, we aimed to determine the factors impacting on WRF and inhospital mortality in patients with AHF.
Methods: During a 9-month period (September 2016 to May 2017), 104 patients with an episode of AHF (mean age: 75 y) were included in this study. The effects of demographic, echocardiographic, and laboratory findings on WRF and in-hospital outcomes (mortality and urgent heart transplantation) were evaluated retrospectively.
Results: Out of the 104 patients, 44.3% developed WRF; the incidence of in-hospital mortality and heart transplantation was 13.4%. Among the laboratory parameters, the specific gravity of urine was significantly associated with WRF (P = 0.03), and higher blood uric acid levels (P = 0.01) and lower left ventricular ejection fractions (P = 0.04) were associated with adverse in-hospital outcomes. Additionally, low hemoglobin (P = 0.03), high pro-BNP (P = 0.05), and low left ventricular ejection fractions (P = 0.04) were associated with a prolonged in-hospital stay.
Conclusions: Laboratory data can be used upon patient admission to guide the therapy of heart failure in an attempt to reduce WRF and in-hospital stay.

Keywords

References

1. McMurray JJ, Adamopoulos S, Anker SD,
Auricchio A, Böhm M, Dickstein K, et al. ESC
Guidelines for the diagnosis and treatment of
acute and chronic heart failure 2012. Eur J Heart
Fail. 2012;14(8):803–869.
2. Gerber Y, Weston SA, Redfield MM,
Chamberlain AM, Manemann SM, Jiang R, et
al. A contemporary appraisal of the heart failure
epidemic in Olmsted County, Minnesota, 2000
to 2010. JAMA Intern Med. 2015;175(6):996–
1004.
3. Bader FM, Attallah N. Insights into cardiorenal
interactions in acute decompensated heart
failure. Curr Opin Cardiol. 2017;32(2):203–208.
4. Forman DE, Butler J, Wang Y, Abraham WT,
O’Connor CM, Gottlieb SS, et al. Incidence,
predictors at admission, and impact of
worsening renal function among patients hospitalized with heart failure. J Am Coll
Cardiol. 2004;43(1):61–67.
5. Bader FM, Attallah N. Insights into cardiorenal
interactions in acute decompensated heart
failure. Curr Opin Cardiol. 2017;32(2):203–208.
6. Cowie MR, Komajda M, Murray-Thomas T,
Underwood J, Ticho B. Prevalence and impact
of worsening renal function in patients
hospitalized with decompensated heart failure:
results of the prospective outcomes study in
heart failure (POSH). Eur Heart J.
2006;27(10):1216–1222.
7. Verdiani V, Lastrucci V, Nozzoli C. Worsening
renal function in patients hospitalized with acute
heart failure: risk factors and prognostic
significances. Int J Nephrol. 2011;2011.
8. Metra M, Nodari S, Parrinello G, Bordonali T,
Bugatti S, Danesi R, et al. Worsening renal
function in patients hospitalised for acute heart
failure: clinical implications and prognostic
significance. Eur J Heart Fail. 2008;10(2):188–
195.
9. Soltani MH, Alemzadeh-Ansari MJ, Taghavi S,
Ghadrdoost B, Maleki M, Amin A, Naderi N.
Worsening Renal Function in Acute
Decompensated Systolic Heart Failure;
Observations from RASHF Registry, an Iranian
Heart Failure Registry. International
Cardiovascular Research Journal 11 (1), 18-24
10. Bui AL, Horwich TB, Fonarow GC.
Epidemiology and risk profile of heart failure.
Nat Rev Cardiol. 2011;8(1):30–41.
11. Yamasaki N, KlTAOKA H, Matsumura Y,
Furuno T, NlSHINAGA M, Doi Y. Heart failure
in the elderly. Intern Med. 2003;42(5):383–388.
12. Stuempfle KJ, Drury DG. Comparison of 3
methods to assess urine specific gravity in
collegiate wrestlers. J Athl Train.
2003;38(4):315.
13. Fischbach FT, Dunning MB. A manual of
laboratory and diagnostic tests. Lippincott
Williams & Wilkins; 2009.
14. Udani SM, Koyner JL. The effects of heart
failure on renal function. Cardiol Clin.
2010;28(3):453–465.
15. Luchner A, Stevens TL, Borgeson DD, Redfield
M, Wei C-M, Porter JG, et al. Differential atrial
and ventricular expression of myocardial BNP
during evolution of heart failure. Am J PhysiolHeart Circ Physiol. 1998;274(5):H1684–H1689.
Iranian Heart Journal
Volume 20, Issue 3
July 2019
Pages 60-65

Files

Share

How to cite

Statistics