Heart failure types and predictors of 30-day rehospitalisation among patients aged ≥ 60 years with acute heart failure: a multicentre prospective study in Vietnam

The burden of heart failure (HF) is increasing due to global population ageing. However, there is limited information on the prevalence and adverse outcomes of different HF types among older patients with acute HF. This study aimed to investigate the prevalence of HF types and identify predictors of 30-day rehospitalisation among patients aged ≥ 60 years with acute HF. This multicentre prospective study included patients aged ≥ 60 years with acute HF. Patients were followed for 30 days post-discharge. Predictors of rehospitalisation for HF were analysed using Cox proportional hazards regression. Of the 277 patients (median age, 76 years [interquartile range, 67–82.5]; male, 46.2%), the prevalence of HF with reduced ejection fraction (HFrEF), HF with mildly reduced ejection fraction (HFmrEF), and HF with preserved ejection fraction (HFpEF) was 49.5%, 20.5%, and 30.0%, respectively. During the 30-day follow-up, rehospitalisation for HF occurred in 42 patients (30.7%) in the HFrEF group, 12 patients (21.1%) in the HFmrEF group, and 12 patients (14.5%) in the HFpEF group (P = 0.02). Significant predictors of rehospitalisation for HF included pulmonary artery systolic pressure (PASP) ≥ 40 mmHg (hazard ratio [HR], 2.37; 95% confidence interval [CI], 1.39–4.03; P = 0.002) and guideline-directed medical therapy (GDMT) (HR, 0.50; 95% CI, 0.25–0.97; P = 0.040). Among patients aged ≥ 60 years with acute HF, HFrEF was the most prevalent type and had the highest incidence of 30-day rehospitalisation. Elevated PASP was associated with an increased risk of rehospitalisation, while GDMT was linked to a reduced risk.