Factors Associated with Mortality in Patients with Chronic Heart Failure During an 18-Month Follow-up Period

Background — Chronic heart failure (CHF) is one of the leading causes of mortality. Many factors can influence the risk of mortality in patients with CHF. Therefore, it is necessary to clarify the predictors of mortality in patients with CHF. The goal of our study was to identify predictors of adverse prognosis in patients with CHF. Methods — The study included 591 patients with CHF at 60 medical facilities registered in Samara Region CHF Registry during one month in 2022. Their median age was 71.0 (64.0-80.0) years, and 339 (57.4%) of them were men. The follow-up period lasted 18 months, during which 198 (33.5%) patients died. Results — According to the results of multivariate analysis, prognostic factors associated with mortality in patients with CHF were age (OR 1.024, 95% confidence interval [CI] 1.007-1.042, p=0.006), NYHA functional class IV (OR 2.226, 95% CI 1.358-3.649, p=0.002), pleural effusion (OR 1.423, 95% CI 0.973-2.083, p=0.069), oxygen therapy in outpatient settings (2.401, 95% CI 0.963-5.988, p=0.06), inotropic therapy in a hospital settings (OR 1.559, 95% CI 0.924-2.630, p=0.096), and left ventricular ejection fraction (LVEF) < 40% (OR 1.580, 95% CI 1.066-2.342, p=0.023). Previous cardiac surgery was inversely associated with the probability of death (OR 0.476, 95% CI 0.3-0.755, p=0.002). The area under the ROC curve, corresponding to the relationship between mortality and the value of the logistic regression function, was 0.691 (p=0.023) (95% CI 0.645-0.736). Conclusion — Predictors of mortality in patients with CHF over an 18-month follow-up period include age, NYHA functional class IV CHF, pleural effusion, oxygen therapy in outpatient settings, inotropic therapy in a hospital setting, and LVEF < 40%. Previous cardiovascular surgeries had a favorable effect on mortality in these patients.