Long-term outcomes of hospitalised patients with de novo and acute decompensated heart failure

Layla Badawy; Anawinla Ta Anyu; Matthew Sadler; Aamir Shamsi; Hannah Simmons; Mohammad Albarjas; Susan Piper; Paul A. Scott; Theresa A. McDonagh; Antonio Cannata; Daniel I. Bromage

doi:10.1016/j.ijcard.2025.133061

Abstract

Aims

Hospital admission for heart failure (HF) is associated with increased mortality risk. Patients admitted with HF can be divided into those with a known previous diagnosis of HF and de novo cases. However, few studies have compared these groups. We compared long-term outcomes of patients with de novo versus acute decompensated HF (ADHF).

Methods and results

We included data from two London hospitals, King's College Hospital and Princess Royal University Hospital. Data from all admissions were collected from the National Institute for Cardiovascular Outcomes and Research (NICOR) National Heart Failure Audit (NHFA) between 2020 and 2021. The outcome measure was all-cause mortality.

A total of 561 patients were included in the study. One third (29 %) were de novo hospitalisations. Over a median follow-up of 15 (interquartile range 4–21) months, 257 (46 %) patients died. Hospitalisation for ADHF was associated with higher all-cause mortality during follow-up (51 % vs 34 %, p < 0.001). In adjusted models, hospitalisation for ADHF remained independently associated with higher all-cause mortality during follow-up (HR 0.60, 95 % CI 0.38–0.96; p = 0.03).

Conclusion

Amongst patients hospitalised for HF, having a history of HF is associated with a higher risk of all-cause mortality than de novo cases. This may have implications for randomised studies that do not routinely document patients' HF history. Prospective studies are needed to elucidate the risk profiles of these two distinct populations for better risk stratification.

Original language	English
Article number	133061
Journal	International Journal of Cardiology
Volume	425
Early online date	19 Feb 2025
DOIs	https://doi.org/10.1016/j.ijcard.2025.133061
Publication status	Published - 15 Apr 2025

Keywords

Acute heart failure
De novo
Decompensated
Mortality
Outcome

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Cite this

@article{a9320b926f77454fa2e644b5b6785cac,

title = "Long-term outcomes of hospitalised patients with de novo and acute decompensated heart failure",

abstract = "AimsHospital admission for heart failure (HF) is associated with increased mortality risk. Patients admitted with HF can be divided into those with a known previous diagnosis of HF and de novo cases. However, few studies have compared these groups. We compared long-term outcomes of patients with de novo versus acute decompensated HF (ADHF).Methods and resultsWe included data from two London hospitals, King's College Hospital and Princess Royal University Hospital. Data from all admissions were collected from the National Institute for Cardiovascular Outcomes and Research (NICOR) National Heart Failure Audit (NHFA) between 2020 and 2021. The outcome measure was all-cause mortality.A total of 561 patients were included in the study. One third (29 %) were de novo hospitalisations. Over a median follow-up of 15 (interquartile range 4–21) months, 257 (46 %) patients died. Hospitalisation for ADHF was associated with higher all-cause mortality during follow-up (51 % vs 34 %, p < 0.001). In adjusted models, hospitalisation for ADHF remained independently associated with higher all-cause mortality during follow-up (HR 0.60, 95 % CI 0.38–0.96; p = 0.03).ConclusionAmongst patients hospitalised for HF, having a history of HF is associated with a higher risk of all-cause mortality than de novo cases. This may have implications for randomised studies that do not routinely document patients' HF history. Prospective studies are needed to elucidate the risk profiles of these two distinct populations for better risk stratification.",

keywords = "Acute heart failure, De novo, Decompensated, Mortality, Outcome",

author = "Layla Badawy and {Ta Anyu}, Anawinla and Matthew Sadler and Aamir Shamsi and Hannah Simmons and Mohammad Albarjas and Susan Piper and Scott, {Paul A.} and McDonagh, {Theresa A.} and Antonio Cannata and Bromage, {Daniel I.}",

note = "Publisher Copyright: {\textcopyright} 2025 The Authors",

year = "2025",

month = apr,

day = "15",

doi = "10.1016/j.ijcard.2025.133061",

language = "English",

volume = "425",

journal = "International Journal of Cardiology",

issn = "0167-5273",

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TY - JOUR

T1 - Long-term outcomes of hospitalised patients with de novo and acute decompensated heart failure

AU - Badawy, Layla

AU - Ta Anyu, Anawinla

AU - Sadler, Matthew

AU - Shamsi, Aamir

AU - Simmons, Hannah

AU - Albarjas, Mohammad

AU - Piper, Susan

AU - Scott, Paul A.

AU - McDonagh, Theresa A.

AU - Cannata, Antonio

AU - Bromage, Daniel I.

PY - 2025/4/15

Y1 - 2025/4/15

N2 - AimsHospital admission for heart failure (HF) is associated with increased mortality risk. Patients admitted with HF can be divided into those with a known previous diagnosis of HF and de novo cases. However, few studies have compared these groups. We compared long-term outcomes of patients with de novo versus acute decompensated HF (ADHF).Methods and resultsWe included data from two London hospitals, King's College Hospital and Princess Royal University Hospital. Data from all admissions were collected from the National Institute for Cardiovascular Outcomes and Research (NICOR) National Heart Failure Audit (NHFA) between 2020 and 2021. The outcome measure was all-cause mortality.A total of 561 patients were included in the study. One third (29 %) were de novo hospitalisations. Over a median follow-up of 15 (interquartile range 4–21) months, 257 (46 %) patients died. Hospitalisation for ADHF was associated with higher all-cause mortality during follow-up (51 % vs 34 %, p < 0.001). In adjusted models, hospitalisation for ADHF remained independently associated with higher all-cause mortality during follow-up (HR 0.60, 95 % CI 0.38–0.96; p = 0.03).ConclusionAmongst patients hospitalised for HF, having a history of HF is associated with a higher risk of all-cause mortality than de novo cases. This may have implications for randomised studies that do not routinely document patients' HF history. Prospective studies are needed to elucidate the risk profiles of these two distinct populations for better risk stratification.

AB - AimsHospital admission for heart failure (HF) is associated with increased mortality risk. Patients admitted with HF can be divided into those with a known previous diagnosis of HF and de novo cases. However, few studies have compared these groups. We compared long-term outcomes of patients with de novo versus acute decompensated HF (ADHF).Methods and resultsWe included data from two London hospitals, King's College Hospital and Princess Royal University Hospital. Data from all admissions were collected from the National Institute for Cardiovascular Outcomes and Research (NICOR) National Heart Failure Audit (NHFA) between 2020 and 2021. The outcome measure was all-cause mortality.A total of 561 patients were included in the study. One third (29 %) were de novo hospitalisations. Over a median follow-up of 15 (interquartile range 4–21) months, 257 (46 %) patients died. Hospitalisation for ADHF was associated with higher all-cause mortality during follow-up (51 % vs 34 %, p < 0.001). In adjusted models, hospitalisation for ADHF remained independently associated with higher all-cause mortality during follow-up (HR 0.60, 95 % CI 0.38–0.96; p = 0.03).ConclusionAmongst patients hospitalised for HF, having a history of HF is associated with a higher risk of all-cause mortality than de novo cases. This may have implications for randomised studies that do not routinely document patients' HF history. Prospective studies are needed to elucidate the risk profiles of these two distinct populations for better risk stratification.

KW - Acute heart failure

KW - De novo

KW - Decompensated

KW - Mortality

KW - Outcome

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DO - 10.1016/j.ijcard.2025.133061

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