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Prognostic Clinical Phenotypes of Patients With Acute Decompensated Heart Failure Publisher Pubmed



Mohammadi T1 ; Tofighi S2 ; Mohammadi B3 ; Halimi S4 ; Gharebakhshi F5
Authors
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Authors Affiliations
  1. 1. College of Science, School of Mathematics, Statistics, and Computer Science, University of Tehran, Tehran, Iran
  2. 2. Department of Cardiology, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Independent Researcher, Unit 5, No 41, 24th Eastern Alley, Azadegan Blvd., Northern Kargar St., Tehran, 1437696156, Iran
  4. 4. Department of General Medicine, Faculty of Medicine, BooAli Hospital, Islamic Azad University of Medical Sciences, Tehran, Iran
  5. 5. Department of Radiology, Imam Hossein Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Source: High Blood Pressure and Cardiovascular Prevention Published:2023


Abstract

Introduction: Acute decompensated heart failure (AHF) is a clinical syndrome with a poor prognosis. Aim: This study was conducted to identify clusters of inpatients with acute decompensated heart failure that shared similarities in their clinical features. Methods: We analyzed data from a cohort of patients with acute decompensated heart failure hospitalized between February 2013 and January 2017 in a Department of Cardiology. Patients were clustered using factorial analysis of mixed data. The clusters (phenotypes) were then compared using log-rank tests and profiled using a logistic model. In total, 458 patients (255; 55.7% male) with a mean (SD) age of 72.7 (11.1) years were included in the analytic dataset. The demographic, clinical, and laboratory features were included in the cluster analysis. Results: The two clusters were significantly different in terms of time to mortality and re-hospitalization (all P < 0.001). Cluster profiling yielded an accurate discriminating model (AUC = 0.934). Typically, high-risk patients were elderly females with a lower estimated glomerular filtration rate and hemoglobin on admission compared to the low-risk phenotype. Moreover, the high-risk phenotype had a higher likelihood of diabetes type 2, transient ischemic attack/cerebrovascular accident, previous heart failure or ischemic heart disease, and a higher serum potassium concentration on admission. Patients with the high-risk phenotype were of higher New York Heart Association functional classes and more positive in their medication history. Conclusions: There are two phenotypes among patients with decompensated heart failure, high-risk and low-risk for mortality and re-hospitalization. They can be distinguished by easy-to-measure patients’ characteristics. © 2023, Italian Society of Hypertension.