Major clinical characteristics of patients surviving 24 months or more after hospitalization due to decompensated heart failure

To study the major clinical characteristics of patients with heart failure who survived more than 24 months after hospitalization for compensation. The study comprised 126 patients with heart failure in functional class III or IV, with a mean age of 51.7 years. Most patients were men (73%), had a mean ejection fraction (EF) of 0.36 and left ventricular diastolic diameter (DD) of 7.13 cm. The major clinical and laboratory characteristics were assessed, and, on follow-up, 25 (19.8%) patients, who survived more than 24 months after hospital discharge, were identified. Data of survivors (G1) were compared with those of patients who died (G2) before 24 months. In G1, the following levels were greater: serum sodium (138.3+/-3.4 vs 134.5+/-5.8 mEq/L; P=0.001); blood pressure levels (120.0 vs 96.7 mm Hg; P=0.003); and LVEF levels (0.40+/-0.08 vs 0.34+/-0.09; P=0.004); and the following levels were lower: urea (59.8 vs 76.3 mg/dL; P=0.007); prothrombin time (12.9 vs 14.8 seconds; P=0.001); LVDD (6.78+/-0.55 vs 7.22+/-0.91; P=0.003); and LA diameter (4.77 vs 4.99 cm; P=0.0003). More survivors were found among patients with idiopathic cardiomyopathy and arterial hypertension than among patients with Chagas' disease and coronary artery disease. In multivariate analysis, the following variables remained as independent predictors of mortality: LVDD > 7.8 cm (HR 1.95); Na < 132 mEq/L (HR 2.30); and prothrombin time > 14 seconds (HR 1.69). The study allowed predicting which patients with heart failure will have a good survival after hospital discharge and those with a greater chance of a long survival after discharge.