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Dear Colleagues,

As a result of the ongoing demographic changes, the overall incidence of patients with heart failure (HF) is increasing worldwide. Despite the ongoing advances in the management of HF, including improved strategies for coronary revascularization, pharmacotherapies and invasive cardiac devices, HF is still characterized by 1-year mortality rates of 10-35%. Risk stratification in patients with HF is complex and the measurement of left ventricular ejection fraction (LVEF) remains the most commonly used tool for decision-making in HF. With the publication of the 2021 ESC guidelines for the management of HF, risk stratification for HF has even become more difficult with the introduction of HF with mildly reduced ejection fraction (HFmrEF), which represents a largely unexplored category of HF patients with very limited evidence. Furthermore, most randomized controlled trials in the field of HF were published more than one decade ago; however, now, clinical characteristics of HF patients have significantly changed, resulting in a larger proportion of older and multi-morbid patients. The scope of this Special Issue is to provide an overview of recent advances in the management of patients with HF. Therefore, researchers in the field of HF are encouraged to submit an original article or review to this Special Issue (case reports and short reviews are not accepted).

Dr. Tobias Schupp
Prof. Dr. Michael Behnes
Guest Editors

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Keywords

heart failure
heart failure with mildly reduced ejection fraction
cardiomyopathies
coronary artery disease
coronary revascularization
mortality

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11 pages, 1518 KiB

Open AccessArticle

Effect of Cardiovascular Risk Factors on 30-Day All-Cause Mortality in Cardiogenic Shock

by Jan Forner, Tobias Schupp, Kathrin Weidner, Marinela Ruka, Sascha Egner-Walter, Michael Behnes, Muharrem Akin, Mohamed Ayoub, Kambis Mashayekhi, Ibrahim Akin and Jonas Rusnak

J. Clin. Med. 2023, 12(14), 4870; https://doi.org/10.3390/jcm12144870 - 24 Jul 2023

Cited by 1 | Viewed by 823

Abstract

Although previous studies investigated the influence of cardiovascular risk (CVR) factors in patients with acute coronary syndrome, data concerning the effect of CVR factors on the prognosis of patients with cardiogenic shock (CS) is scarce. Consecutive patients with CS were prospectively included from 2019 to 2021. The prognosis of patients with “low CVR” (i.e., 0–1 CVR factors) was compared to patients with “high CVR” (i.e., 2–4 CVR factors) according to presence or absence of arterial hypertension, diabetes mellitus, hyperlipidaemia or smoking. The primary endpoint was 30-day all-cause mortality. Statistical analyses included Kaplan-Meier and Cox proportional regression analyses. 273 consecutive patients with CS were included. 28% presented with low CVR and 72% with high CVR. Within the entire study cohort, the risk of 30-day all-cause mortality did not differ between patients with high and low CVR (55% vs. 57%; log rank p = 0.727; HR = 0.942; 95% CI 0.663–1.338; p = 0.738). Even after multivariable adjustment, high CVR was not associated with an elevated risk of 30-day all-cause mortality (HR = 1.039; 95% CI 0.648–1.667; p = 0.873). The presence of arterial hypertension (55% vs. 58%; log rank p = 0.564; HR = 0.906; 95% CI 0.638–1.287; p = 0.582), diabetes mellitus (60% vs. 52%; log rank p = 0.215; HR = 1.213; 95% CI 0.881–1.671; p = 0.237) and a history of smoking (56% vs. 56%; log rank p = 0.725; HR = 0.945; 95% CI 0.679–1.315; p = 0.737) did not significantly influence short-term prognosis.. Only the absence of hyperlipidaemia significantly decreased the risk of all-cause mortality (65% vs. 51%; log rank p = 0.038; HR = 0.718; 95% CI 0.516–0.998; p = 0.049), which was no longer observed after multivariable adjustment (HR = 0.801; 95% CI 0.536–1.195; p = 0.277). In conclusion, neither the overall CVR nor individual CVR factors were associated with the risk of 30-day all-cause mortality in patients with CS. Full article

(This article belongs to the Special Issue Facing the Heart Failure Pandemic: Recent Advances in Heart Failure Management)

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