Prognostic Implications of Heart Failure Rehospitalization in Adults with CHD & Clinical Benefits of Medical Therapy

Prognostic Implications of Heart Failure Rehospitalization in Adults with CHD & Clinical Benefits of Medical Therapyhttps://doi.org/10.1016/j.ijcchd.2025.100640 ABSTRACTBackground The risk factors for heart failure (HF) rehospitalization, and the effect of guideline directed medical therapy (GDMT)are poorly understood in adults with congenital heart disease (ACHD). We aimed to describe the outcomes of heart failure hospitalization and to assess the clinical benefits of guideline directed medical therapy for heart failure. MethodsWe conducted a retrospective cohort study of adults with congenital heart disease hospitalized for heart failure at MayoClinic from 2003 to 2023. Cox proportional hazard models were used to determine the predictors of heart failure rehospitalization and all-cause mortality, and to assess the association between death and guideline directed medical therapy, as measured by the Heart Failure Collaborative score. ResultsOf the 324 patients, 164 were rehospitalized for heart failure and 149 died. The 10-year cumulative incidence of rehospitalization was 75.8% (95% CI 70.1%-81.5%), and the 10-year survival rate from mortality was 47.3% (95%CI 40.9%-54.7%). Chronic kidney disease (HR 1.46, 95% CI 1.06-2.01, p=0.021) and Fontan physiology (HR 1.59, 95%CI 1.02-2.49, p=0.043) were associated with heart failurerehospitalization. Heart failure rehospitalization within 1 year was associated with nearly a 3-fold increased risk of mortality (HR 2.88, 95% CI 2.00-4.15, p<0.001). The HFC score was associated with a lower risk of all-cause mortality (HR 0.77, 95% CI 0.62-0.95, p= 0.016) in the subgroup of patients with reduced ejection fraction. ConclusionsAmong adults with congenital heart disease hospitalized for heart failure, half of the patients were rehospitalized for heartfailure. Rehospitalization within 1 year of the index heart failure hospitalization was associated with mortality. The use of guideline-directed medical therapy for heart failure was associated with improved survival in patients with reduced ejection fraction. Disclaimer:Lupin makes no representation or warranty of any kind, expressed or implied, regarding the accuracy, adequacy, validity, reliability, availability, or completeness of any scientific information shared by the HCP on the ­­­STARUPDATE podcast. You should not allow the contents of this to substitute for your own medical judgment, which you should exercise in evaluating the information on this website.