Aim: Stratification of risk factors of 2-year mortality of patients with (CHF)
Methods: Retrospective analysis of medical records of patients dissmised from the Internal Cardiology Dpt. in Oct-Dec 2004.
Results: We analysed 839 patients. CHF diagnosis criteria sutisfied 144 (17,2%),mean age 68,2 years.2-year mortality of non-CHF was 8,9%,of CHF patients 27,1% (p<0,00001), NYHA<III 22,2% and NYHA>III 35,2% (p=0,09). Comparing comorbidities of surviving and non-surviving patients,there were 74,3% vs 79,5% with IHD,61,0% vs 59,0% suffered cardiac infarction,65,7% vs 64,1% with HT,41,9% vs 46,2% with atrial fibrillation in anamnesis,20,0% vs 12,8% with dilated CMP and 33,3% vs 46,2% with DM (all NS).In haemodynamics, systolic BP was 124,8 vs 119,5mmHg,heart rate 73,0 vs 75,3/min,pulse BP 50,2 vs 51,3mmHg (all NS),diastolic BP 74,7 vs 68,2mmHg (p<0,01),mortality was higher in patients with left ventricule (LV) EF<25% (p<0,05).In lab,mean cholesterol (CH) was 4,85 vs 4,20mmol/l,LDL-CH 2,93 vs 2,23mmol/l (both p<0.05),HDL-CH and triglycerides (TG) were decreased in dead (NS),blood urea was 7,7 vs 11,3mmol/l,creatinine 110,7 vs 141,2umol/l,uric acid 395,8 vs 488,5umol/l,haemoglobin 138,7 vs 123,9g/l (all p<0,01).In medication,betablockers (BB) had at dismissal 82% vs 72%,diuretics 84% vs 87%,digitalis 32% vs 36%,spironolactone 54% vs 56%,anticoagulation 18% vs 8% (NS),ACE-i/ARB 90% vs 72% (p<0,01), BB+ACE-i/ARB combination 76% vs 59% (p<0.05).
Conclusion: 2-year mortality of patients with CHF is 3,5x higher than patiens without CHF.Negative impact had elevated nitrogen substances,uric acid,lowered total and LDL-CH,low diastolic BP,severe systolic LV dysfunction,anaemia.Monitored comorbidities did not influence mortality separately but by mutual intensification of negative affects.Positive affect on mortality had ACE-i/ARB,their combination with BB and anticoagulation .