Repullo, DanielFuentes, LidiaAnaya Bustos, SaraMiñana, GemmaLlorens Soriano, PereMiró i Andreu, ÒscarRomero-Carrete, Carlos JoseAlquézar Arbé, AitorNuñez, JulioGil Espinosa, VictorJacob, JavierAguirre, AlfonsVillarejo Jimenez, AnaBorja-Cano, Mariade la Espriella, RafaelSantas, EnriqueSánchez Marcos, Carolina2025-11-032025-11-030022-9032https://hdl.handle.net/2445/224057Introduction: Acute heart failure (AHF) represents a critical event in heart failure progression, but data on long-term outcomes after first hospitalization remain scarce. The aim is to describe long-term survival and evaluate its predictors after the first episode of AHF. Material and methods: Patients from five Spanish hospitals with a confirmed first diagnosis of AHF were categorized based on survival (≥5 or <5 years). Thirteen independent variables were identified. Mortality was assessed using Kaplan-Meier curves after up to 10 years of follow-up. Adjusted odds ratios (OR) with 95% confidence intervals (CI) for mortality were calculated. Additionally, adjusted survival probabilities according to patient age and left ventricular ejection fraction (LVEF) were obtained using restricted cubic splines. Results: A total of 1986 patients were included, with a median age 76 years (range: 68-82), 50% women, and 57% with preserved LVEF. Five-year mortality was 52%. Adjusted analysis showed that age (OR, 0.470 per 10-year increment; 95% CI, 0.421-0.525), New York Heart Association class III-IV vs. I (OR, 0.476; 95% CI, 0.341-0.666) and II vs. I (OR, 0.780; 95% CI, 0.627-0.969), chronic kidney disease (OR, 0.609; 95% CI, 0.452-0.820), coronary artery disease (OR, 0.657; 95% CI, 0.523-0.824), diabetes mellitus (OR, 0.658; 95% CI, 0.534-0.811), and male sex (OR, 0.774; 95% CI, 0.625-0.958) were associated with death within 5 years. LVEF at inclusion was not related to 5-year survival. Conclusions: Survival after a first AHF episode is poor, with age, New York Heart Association class, kidney function, coronary artery disease, diabetes, and sex being key predictors of long-term mortality.7 p.application/pdfengcc-by-nc-nd (c) Romero-Carrete, C.J. et al., 2025http://creativecommons.org/licenses/by-nc-nd/4.0/MortalitatFactors de risc en les malaltiesInsuficiència cardíacaPersones gransMortalityRisk factors in diseasesHeart failureOlder peopleinfo:eu-repo/semantics/article7614552025-11-03info:eu-repo/semantics/openAccess