Division of Emergency Care, Department of Medicine, Helsinki University Central Hospital, PO Box 340, Helsinki 00029 HUS, Finland.
Eur J Heart Fail. 2010 Mar;12(3):239-48. doi: 10.1093/eurjhf/hfq002.
Acute heart failure (AHF) has a poor prognosis. We evaluated 3- and 12-month mortality in different clinical classes of AHF patients from 30 European countries who were included in the EuroHeart Failure Survey (EHFS) II.
Follow-up data were available for 2981 AHF patients, of these 62% had a history of chronic HF. One-year mortality after discharge was lower in patients with de novo AHF when compared with acutely decompensated chronic HF (ADCHF), 16.4 vs. 23.2% (P < 0.001). Cardiogenic shock conferred the highest cumulative 1-year mortality (52.9%) as a result of in-hospital mortality of 39.3%. Long-term prognosis in decompensated AHF was also dismal. Hypertensive HF was associated with the lowest mortality (13.7% at 1 year). Age, prior myocardial infarction, creatinine level, and low plasma sodium were independently associated with mortality during the whole follow-up period. Diabetes, anaemia, and history of chronic HF were associated with worse and hypertension with better long-term survival. History of cerebrovascular disease was associated with worse short-term outcome.
Early and late mortality differ between de novo AHF and ADCHF and between clinical classes of AHF. EHFS II identifies clinical risk markers and demonstrates the importance of a thorough characterization of AHF populations according to history and clinical presentation.
急性心力衰竭（AHF）预后不良。我们评估了来自 30 个欧洲国家的 3002 名 AHF 患者的 3 个月和 12 个月死亡率，这些患者被纳入欧洲心力衰竭调查（EHFS） II。
2981 名 AHF 患者可获得随访数据，其中 62%有慢性 HF 病史。与急性失代偿性慢性心力衰竭（ADCHF）相比，新发 AHF 患者出院后 1 年死亡率较低，分别为 16.4%和 23.2%（P<0.001）。心源性休克导致 1 年累计死亡率最高（52.9%），院内死亡率为 39.3%。失代偿性 AHF 的长期预后也很差。高血压性 HF 死亡率最低（1 年时为 13.7%）。年龄、既往心肌梗死、肌酐水平和低血浆钠与整个随访期间的死亡率独立相关。糖尿病、贫血和慢性 HF 病史与较差的长期生存相关，而高血压与更好的长期生存相关。脑血管疾病史与短期预后不良相关。
新发 AHF 和 ADCHF 以及 AHF 的临床分类之间的早期和晚期死亡率不同。EHFS II 确定了临床风险标志物，并证明根据病史和临床表现对 AHF 人群进行全面特征描述的重要性。
