| Ejection fraction and blood pressure are important and interactive predictors of 4-week mortality in severe acute heart failure. | |
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MedLine Citation:
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PMID: 17627880 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: In acute heart failure syndromes (AHFS), the prognostic value of left ventricular ejection fraction (LVEF), although widely accepted, has been recently challenged. In contrast, blood pressure is increasingly gaining ground over LVEF as predictor of mortality. Therefore, it is not clear whether both LVEF and mean arterial pressure (MAP) are independent risk factors in patients with AHFS. METHODS AND RESULTS: The EFICA study enrolled 581 AHFS patients admitted to 60 CCU/ICUs. Survival at 4 weeks was analyzed for all cases with echocardiographic LVEF available on admission (n=355). Four-week mortality was 23%. Multivariable analysis identified lower LVEF, lower MAP and serum creatinine >1.5 mg/dl as independent correlates of mortality (respectively, OR: 1.27 per 10% decrease, CI: 1.05-1.53, p=0.012; OR: 1.30 per 10 mmHg decrease, CI: 1.15-1.48, p<0.0001; OR: 2.84, CI: 1.64-4.93, p=0.0002). LVEF interacted significantly with MAP (p<0.0001) and the subgroup analysis showed that reduced LVEF was a strong risk factor in patients with MAP <or=90 mmHg (OR: 2.73, CI: 1.23-5.98, p=0.01) but did not reach statistical significance in patients with MAP >90 mmHg. CONCLUSIONS: Both LVEF and MAP are important predictors of death in severe AHFS. LVEF can provide additional prognostic information on top of MAP but mainly in patients with low MAP (<or=90 mmHg) at admission. |
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Authors:
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Chris Adamopoulos; Faiez Zannad; Renaud Fay; Alexandre Mebazaa; Alain Cohen-Solal; Louis Guize; Yves Juillière; François Alla |
Publication Detail:
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Type: Clinical Trial; Journal Article Date: 2007-07-12 |
Journal Detail:
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Title: European journal of heart failure Volume: 9 ISSN: 1388-9842 ISO Abbreviation: Eur. J. Heart Fail. Publication Date: 2007 Sep |
Date Detail:
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Created Date: 2007-09-03 Completed Date: 2007-11-13 Revised Date: 2011-06-08 |
Medline Journal Info:
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Nlm Unique ID: 100887595 Medline TA: Eur J Heart Fail Country: Netherlands |
Other Details:
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Languages: eng Pagination: 935-41 Citation Subset: IM |
Affiliation:
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Clinical Investigation Center of Nancy, France. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Aged Aged, 80 and over Blood Pressure* Creatinine / blood Female Follow-Up Studies Heart Failure / blood, mortality*, physiopathology Humans Male Middle Aged Prognosis Risk Factors Stroke Volume* |
| Chemical | |
Reg. No./Substance:
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60-27-5/Creatinine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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