Author + information
- Jamal S. Rana,
- Dustin Mark,
- Jie Huang,
- Adina S. Rauchwerger,
- Mary E. Reed and
- Dana R. Sax
There is limited analysis of patients treated in emergency departments (ED) for heart failure (HF), especially by left ventricular ejection fraction (EF) status. We evaluated outcomes among patients treated in the ED for HF with preserved (HFpEF, ≥ 50%) and reduced (HFrEF, < 50%) EF.
Retrospective, multi-center, cohort study of patients with an ED visit for acute HF during 2016-2017, in an integrated delivery system with 21 medical centers. Eligible patients were identified using ICD-10 codes, laboratory values, ED chief complaint, and Framingham HF criteria. We compared age-adjusted rates of adverse events within 30 days of ED presentation, including death, endotracheal intubation, renal failure requiring dialysis, and myocardial infarction or coronary revascularization between HFpEF and HFrEF patients with results from logistic regression models adjusted for age.
Among 15,339 patients with EF status, mean age was 74 years, 49.6% were women, 60.6% were white and 68.3% had HFpEF. Rates of 30-day composite adverse events were statistically significantly higher among HFrEF patients (p<0.001), driven by myocardial infarction and coronary revascularization (p<0.001). All-cause mortality rates were statistically non-significant between the two groups (Figure).
Among patients presenting to an ED with acute HF with known EF, two thirds had HFpEF; both groups had similar mortality. Managing patients with HFpEF is an emerging challenge for ED physicians.
Posters Hall_Hall A
Sunday, March 29, 2020, 10:00 a.m.-10:45 a.m.
Session Title: Heart Failure and Cardiomyopathies: Clinical 4
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1260-120
- 2020 American College of Cardiology Foundation