Predictors of Decreased Morbidity and Hospitalization After Incident Heart Failure

Project: Research project

Project Details

Description

Desai and Stevenson describe a three-phase topology of heart failure (HF). First is the “transition
phase,” a period of heightened risk for readmission/adverse events following an index
hospitalization for acute decompensated HF. Second is the “plateau phase,” a time of chronic,
stable HF. Third is the “Phase of Palliation and Priorities,” representing advanced HF, frequent
hospitalizations, and heightened mortality. As a fellow caring for patients hospitalized with HF, I
have observed through histories and chart reviews that many patients with HF stabilize on a medical HF regimen, achieving many years free from recurrent hospitalization (a long “plateau phase”). Others, despite optimal medical therapy, achieve a rather attenuated “plateau phase”, transitioning rapidly into phase three. Why does this discrepancy in HF trajectory between patients exist?

The Cardiovascular Lifetime Risk Pooling Project is a large individual-level pooled dataset
comprised of 18 US community-based cohorts housed at Northwestern. Conveniently, adjudicated
HF outcomes exist within these large cohorts in addition to detailed clinical, socioeconomic,
diagnostic, and biochemical data on each of the participating subjects. My aim is to identify
predictors of a prolonged “plateau phase” after a diagnosis of incident HF. I hypothesize that in
addition to treatment with evidence-based therapies, there are variables occurring antecedent to the incident HF and during the early part “plateau phase” predictive of HF events. Better
characterization of these factors will facilitate the identification of patients at high risk for
hospitalization, allowing for earlier and more aggressive interventions and more informed counseling of patients about prognosis
StatusFinished
Effective start/end date7/1/146/30/16

Funding

  • Heart Failure Society of America, Inc. (AGMT-06/15/15)

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