Heart failure & cardiomyopathies
Clinical Characteristics and Outcomes of Adults with Acute Heart Failure in a South African Teaching Hospital
Authors' conclusion
In our study, HFrEF was the predominant phenotype, and each phenotype exhibited distinct clinical and biomarker profiles. All-cause in-hospital mortality was low and did not differ significantly across the phenotypes. Independent predictors of mortality included markers of inflammation, electrolyte imbalance and moderate-to-severe AR.
Study context
- Population
- Adults admitted with acute heart failure (HF), South African teaching hospital, February–November 2023
- Participants
- 406 adults
- Exposure
- HF with Reduced Ejection Fraction (HFrEF) vs HF with Mildly Reduced Ejection Fraction (HFmrEF) vs HF with Preserved Ejection Fraction (HFpEF)
- HFrEFn = 257
- HFmrEFn = 62
- HFpEFn = 87
- Outcome
- All-cause in-hospital mortality
- Follow-up
- In-hospital
Methodological detailsconsecutive patients, single-centre
- Consecutive patients
- Single-centre
Main finding
As reported in the abstract
- All-cause in-hospital mortality (overall), 95% CI 2.0-6.0
- 3.4%
- No significant variation across left ventricular ejection fraction (LVEF) phenotypes
- P = 0.70
Observational data: associations, not effects.
Further findings
Prevalence of LVEF phenotypes
Predictors of in-hospital mortality (multivariable, adjusted for age and sex)
| OR (95% CI) | P value | ||
|---|---|---|---|
| Higher C-reactive proteinAdjusted for age and sex | 1.02 (1.00–1.03) | P = 0.009 | |
| Elevated neutrophil-lymphocyte ratioAdjusted for age and sex | 1.15 (1.03–1.29) | P = 0.012 | |
| Elevated serum potassiumAdjusted for age and sex | 3.41 (1.23–9.43) | P = 0.018 | |
| Moderate ARAdjusted for age and sex | 12.80 (1.12–101.29) | P = 0.016 | |
| Severe ARAdjusted for age and sex | 34.49 (3.77–353.47) | P = 0.002 | |
| Low DBPReduced mortality risk · adjusted for age and sex | 0.94 (0.89–0.99) | P = 0.045 | |
| 0.050.21520Odds ratio (log scale) |
HFpEF profile vs other phenotypes
- HFpEF older, predominantly female, higher median global longitudinal score, lower NT-proBNP
- P < 0.001
Original publication
Clinical Characteristics and Outcomes of Adults with Acute Heart Failure in a South African Teaching Hospital. ESC Heart Fail. Published 13 August 2025. doi:10.
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