Skip to Main content Skip to Navigation
Journal articles

Temporal trends in mortality and readmission after acute heart failure: A systematic review and meta‐regression in the past four decades

Abstract : Aims: Acute heart failure (AHF) is frequent and life-threatening disease. However, innovative AHF therapies have remained limited, and care is based on experts opinion. Temporal trends and benefits of long-term oral cardiovascular medications on AHF outcomes remain uncertain. Methods and results: This study is registered with PROSPERO (CRD42018099885). A systematic review ranging from 1980 to 2017, searched AHF studies with more than 100 patients that reported death and/or readmission. Primary outcomes were temporal trends, assessed by meta-regression, for 30-day or one-year all-cause death and/or readmission rates. Secondary outcomes were temporal trends of oral cardiovascular therapies and their influence on primary outcomes. Among the 45143 studies screened, 285 were included, representing 15 million AHFs. In the past decades, though mortality and readmission remain high, there was a decline in 30-day all-cause death (OR for a 10-year increment: 0.74 (0.61-0.91); p=0.004) that persisted at one year (OR 0.86 (0.77- 0.96); p=0.007), while 30-day and one-year all-cause readmission rate remained roughly unchanged. Trends of primary outcomes were linear and did not differ among continents. Decline in one-year all-cause death rate correlated with high proportions of oral or beta-blockers, especially when combined with oral renin-angiotensin-aldosterone system inhibitors, but not with diuretics while trends in readmission remained unchanged with these therapies. Conclusions: Though AHF outcomes remain poor, the present study revealed global favorable trends of survival after AHF episodes probably associated with greater use of oral neurohormonal antagonists. The present study urges to implement the combination of oral renin-angiotensin-aldosterone system inhibitors and beta-blockers in patients at risk of AHF. This article is protected by copyright. All rights reserved.
Complete list of metadata

https://hal.univ-lorraine.fr/hal-03114734
Contributor : Erwan Bozec <>
Submitted on : Tuesday, January 19, 2021 - 11:03:35 AM
Last modification on : Wednesday, June 9, 2021 - 4:02:06 PM
Long-term archiving on: : Tuesday, April 20, 2021 - 7:10:21 PM

Files

 Restricted access
To satisfy the distribution rights of the publisher, the document is embargoed until : 2021-07-15

Please log in to resquest access to the document

Identifiers

Citation

Antoine Kimmoun, Koji Takagi, Emmanuel Gall, Shiro Ishihara, Pierre Hammoum, et al.. Temporal trends in mortality and readmission after acute heart failure: A systematic review and meta‐regression in the past four decades. European Journal of Heart Failure, Oxford University Press (OUP), 2021, ⟨10.1002/ejhf.2103⟩. ⟨hal-03114734⟩

Share

Metrics

Record views

180