Acute cardiac care & resuscitation
Prediction of Cardiac Worsening Through to Cardiogenic Shock in Patients with Acute Heart Failure
Authors' conclusion
Half of patients admitted with AHF experience WHF or new-onset CS. Chronic kidney disease, tricuspid valve regurgitation, and elevated pro-adrenomedullin concentrations predict these events.
Study context
- Population
- Consecutive patients hospitalised for acute HF at a large tertiary care centre
- Participants
- 233 patients
- Outcome
- Predictors of worsening HF (RELAX-AHF-2 criteria) or new-onset cardiogenic shock (SCAI stages B-E)
- Follow-up
- Until death or discharge
Methodological detailssingle-centre, consecutive patients
- Single-centre
- Consecutive patients
Main finding
As reported in the abstract
Incidence and predictors of WHF and new-onset CS (logistic regression adjusted for age and sex)
- Worsening of heart failure (WHF) incidence
- 96 (44.2%)
- Cardiogenic shock (CS) incidence
- 18 (9.7%)
- CKD predicting WHF: OR 2.20, 95% CI 1.25-3.93
- P = 0.007
- Log serum creatinine predicting WHF: OR 2.90, 95% CI 1.51-5.82
- P = 0.002
- Cystatin c predicting WHF: OR 1.86, 95% CI 1.27-2.77
- P = 0.002
- Tricuspid valve regurgitation predicting WHF: OR 2.08, 95% CI 1.11-3.94
- P = 0.023
- Log pro-adrenomedullin predicting WHF: OR 3.01, 95% CI 1.75-5.38
- P < 0.001
- CKD predicting CS: OR 3.17, 95% CI 1.16-9.58
- P = 0.03
- Cystatin c predicting CS: OR 1.88, 95% CI 1.00-3.53
- P = 0.045
- Log pro-adrenomedullin predicting CS: OR 2.90, 95% CI 1.19-7.19
- P = 0.019
- Tricuspid valve regurgitation predicting CS: OR 10.44, 95% CI 2.61-70.00
- P = 0.003
Observational data: associations, not effects.
Further findings
- In-hospital death
- 8/223, 3.6%
- Association with WHF: OR 6.64, 95% CI 1.21-36.55
- P = 0.03
- Association with CS: OR 38.27, 95% CI 6.32-231.81
- P < 0.001
Original publication
Prediction of Cardiac Worsening Through to Cardiogenic Shock in Patients with Acute Heart Failure. ESC Heart Fail. Published 17 April 2024. doi:10.
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