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Int J Cardiol. 2016 Dec 1;224:456-460. doi: 10.1016/j.ijcard.2016.09.062. Epub 2016 Sep 17.

Temporal trends in long-term mortality of patients with acute heart failure: Data from 1985-2008.

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Department of Cardiology, Thoraxcentre, Erasmus Medical Centre, Rotterdam, The Netherlands.
Department of Medical Informatics, Erasmus University Medical Centre, Rotterdam, The Netherlands.
Department of Cardiology, Thoraxcentre, Erasmus Medical Centre, Rotterdam, The Netherlands. Electronic address:



Heart failure (HF) has a poor prognosis. Patients with acute heart failure in particular have a high risk of dying. However, there is a lack of data regarding their long-term mortality and changes there-in with time. The aim of our study was to describe trends in short- and long-term mortality of patients hospitalized with acute HF in the period from 1985 through 2008. In addition, we determined the prognostic worth of the aetiology of HF.


We included a consecutive series of 1810 patients with acute HF in this prospective registry in the period of 1985 through 2008. The cumulative one-year mortality rate of the patients was 35%. The short-term prognosis remained unchanged over the decades. However, the cumulative mortality rate ten years after admission was lowest in the last decade (73% in 2000-2008 vs. 78% in 1985-1999, p=0.001). After multivariable adjustment, the ten-year mortality rate was lower in the last decade as compared to the first decade (hazard ratio (HR) 0.83; 95% confidence interval (CI) 0.71-0.96). Ischemic cardiomyopathy was associated with a higher mortality (HR 1.32; 95% CI 1.12-1.54) when compared to other causes of HF.


Patients admitted with acute HF were found to have both high short-term and long-term mortality. Long-term prognostic improvement in the last decade was observed among patients with a reduced ejection fraction. While patients with HF due to valvular heart disease had the best prognosis, an ischemic aetiology of HF was associated with the worst outcome.


Acute heart failure; Epidemiology; Mortality; Trends

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