Acute Precipitants of Congestive Heart Failure Exacerbations

Abstract

DESPITE MANY advances in congestive heart failure (CHF) therapy, worsening of clinical status, often to the point of requiring hospitalization, remains a common occurrence.¹ It is estimated that there are 700 000 hospitalizations for CHF per year in the United States. In the Studies of Left Ventricular Dysfunction registry of 6273 consecutive patients with CHF,² 19% were hospitalized 1 or more times for CHF and 27% died or were hospitalized for CHF within 1 year. In 2 large CHF trials, the Studies of Left Ventricular Dysfunction Treatment Trial³ and the Digitalis Investigation Group Trial,⁴ 26% and 27%, respectively, of patients in the active treatment groups were hospitalized at least once during the 3 to 4 years of follow-up. Indeed, approximately two thirds of the economic burden of CHF is due to hospitalizations for worsening clinical status.⁵