87831 20231027130637.0 doi 10.1016/j.ijcard.2018.01.067 sideral 105392 ART-2018-105392 eng Rubio-Gracia, Jorge Universidad de Zaragoza (orcid)0000-0002-4769-7154 Prevalence, predictors and clinical outcome of residual congestion in acute decompensated heart failure 2018 Access copy available to the general public Unrestricted Background: Congestion is the main reason for hospital admission for acute decompensated heart failure (ADHF). A better understanding of the clinical course of congestion and factors associated with decongestion are therefore important. We studied the clinical course, predictors and prognostic value of congestion in a cohort of patients admitted for ADHF by including different indirect markers of congestion (residual clinical congestion, brain natriuretic peptides (BNP) trajectories, hemoconcentration or diuretic response). Methods and results: We studied the prognostic value of residual clinical congestion using an established composite congestion score (CCS) in 1572 ADHF patients. At baseline, 1528 (97.2%) patients were significantly congested (CCS = 3), after 7 days of hospitalization or discharge (whichever came first), 451 (28.7%) patients were still significantly congested (CCS = 3), 751 (47.8%) patients were mildly congested (CCS = 1 or 2) and 370 (23.5%) patients had no signs of residual congestion (CCS = 0). The presence of significant residual congestion at day 7 or discharge was independently associated with increased risk of re-admissions for heart failure by day 60 (HR [95%CI] = 1.88 [1.39–2.55]) and all-cause mortality by day 180 (HR [95%CI] = 1.54 [1.16–2.04]). Diuretic response provided added prognostic value on top of residual congestion and baseline predictors for both outcomes, yet gain in prognostic performance was modest. Conclusion: Most patients with acute decompensated heart failure still have residual congestion 7 days after hospitalization. This factor was associated with higher rates of re-hospitalization and death. Decongestion surrogates, such as diuretic response, added to residual congestion, are still significant predictors of outcomes, but they do not provide meaningful additive prognostic information. info:eu-repo/semantics/openAccess by-nc-nd http://creativecommons.org/licenses/by-nc-nd/3.0/es/ 3.471 2018 CARDIAC & CARDIOVASCULAR SYSTEMS 48 / 135 = 0.356 2018 Q2 T2 0.99 2018 Cardiology and Cardiovascular Medicine 2018 Q2 info:eu-repo/semantics/article info:eu-repo/semantics/acceptedVersion Demissei, B.G. ter Maaten, J.M. Cleland, J.G. O''Connor, C.M. Metra, M. Ponikowski, P. Teerlink, J.R. Cotter, G. Davison, B.A. Givertz, M.M. Bloomfield, D.M. Dittrich, H. Damman, K. Pérez-Calvo, Juan I. Universidad de Zaragoza (orcid)0000-0003-2361-9941 Voors, A.A. 1007 610 Universidad de Zaragoza Dpto. Medicina, Psiqu. y Derm. Area Medicina 258 (2018), 185-191 Int. j. cardiol. INTERNATIONAL JOURNAL OF CARDIOLOGY 0167-5273 322984 http://zaguan.unizar.es/record/87831/files/texto_completo.pdf Postprint 187641 http://zaguan.unizar.es/record/87831/files/texto_completo.jpg?subformat=icon icon Postprint oai:zaguan.unizar.es:87831 articulos driver 2023-10-27-12:53:00 ARTICLE