English summary: ACUTE HEART FAILURE IN FINLAND

Background

Acute heart failure (HF) is commonly seen in acute cardiac care, but epidemiological data on it is sparse. The Finnish Acute Heart Failure Study (FINN-AKVA) aims to investigate issues related to acute HF, such as its etiology, concomitant diseases, treatment modalities, morbidity and mortality.

Methods

Included in this prospective trial were all consecutive patients (= 622) with exacerbation of chronic HF or new onset of HF, hospitalized during a 2-3 month inclusion period in five university hospitals, four central hospitals and five regional hospitals around Finland.

Results

The patients were characterized according to the new acute HF guidelines as having congestive HF (65%), pulmonary oedema (26%), isolated right HF (5%), cardiogenic shock (2%) or hypertensive crisis (2%). The mean age of the patients was 75 (±10) years and 50% were men. Half of the patients had new onset HF. 55% were known to have coronary heart disease. Diabetes (33%), hypertension (55%), chronic atrial fibrillation (27%) and valvular heart disease (13%) were common risk factors. 33% of the patients presented with acute coronary syndrome. Echocardiography data was available for 2/3 of the patients. 25% had LV-EF < 30% and 33% had EF > 50%. 14% of all patients were treated with inotropes, mostly levosimendan (7%), dopamine (7%), noradrenaline (5%) or dobutamine (4%). In-hospital mortality of all patients was 7%. 58% were discharged home, 30% to another health care facility and 5% to a nursing home. 6-month mortality was 20%.

Conclusions

The morbidity and in-hospital mortality of acute HF patients remain high despite modern treatment.