{"doi":"10.1002/ehf2.14792","title":"Prediction of Cardiac Worsening Through to Cardiogenic Shock in Patients with Acute Heart Failure","abstract":"<jats:title>Abstract</jats:title>\n                  <jats:sec>\n                    <jats:title>Aims</jats:title>\n                    <jats:p>Acute heart failure (AHF) can result in worsening of heart failure (WHF), cardiogenic shock (CS), or death. Risk factors for these adverse outcomes are not well characterized. This study aimed to identify predictors for WHF or new-onset CS in patients hospitalized for AHF.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results</jats:title>\n                    <jats:p>Prospective cohort study enrolling consecutive patients with AHF admitted to a large tertiary care centre with follow-up until death or discharge. WHF was defined by the RELAX-AHF-2 criteria. CS was defined as SCAI stages B–E. Potential predictors were assessed by fitting logistic regression models adjusted for age and sex. N = 233 patients were enrolled, median age was 78 years, and 80 were women (35.9%). Ischaemic cardiomyopathy was present in 82 patients (40.8%). Overall, 96 (44.2%) developed WHF and 18 (9.7%) CS. In-hospital death (8/223, 3.6%) was related to both events (WHF: OR 6.64, 95% CI 1.21–36.55, P = 0.03; CS: OR 38.27, 95% CI 6.32–231.81, P &amp;lt; 0.001). Chronic kidney disease (OR 2.20, 95% CI 1.25–3.93, P = 0.007), logarithmized serum creatinine (OR 2.90, 95% CI 1.51–5.82, P = 0.002), cystatin c (OR 1.86, 95% CI 1.27–2.77, P = 0.002), tricuspid valve regurgitation (OR 2.08, 95% CI 1.11–3.94, P = 0.023) and logarithmized pro-adrenomedullin (OR 3.01, 95% CI 1.75–5.38, P &amp;lt; 0.001) were significant predictors of WHF. Chronic kidney disease (OR 3.17, 95% CI 1.16–9.58, P = 0.03), cystatin c (OR 1.88, 95% CI 1.00–3.53, P = 0.045), logarithmized pro-adrenomedullin (OR 2.90, 95% CI 1.19–7.19, P = 0.019), and tricuspid valve regurgitation (OR 10.44, 95% CI 2.61–70.00, P = 0.003) were significantly with new-onset CS.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions</jats:title>\n                    <jats:p>Half of patients admitted with AHF experience WHF or new-onset CS. Chronic kidney disease, tricuspid valve regurgitation, and elevated pro-adrenomedullin concentrations predict these events. They could potentially serve as early warning signs for further deterioration in AHF patients.</jats:p>\n                  </jats:sec>","journal":"ESC Heart Failure","year":2024,"id":615709,"datarank":0.31191623125197543,"base_score":2.0794415416798357,"endowment":2.0794415416798357,"self_citation_contribution":0.31191623125197543,"citation_network_contribution":0.0,"self_endowment_contribution":0.31191623125197543,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":7,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1587144,"name":"Caroline Kellner","orcid":null,"position":1,"is_corresponding":false},{"id":1587146,"name":"Jonas Sundermeyer","orcid":null,"position":2,"is_corresponding":false},{"id":1587148,"name":"Lisa Besch","orcid":null,"position":3,"is_corresponding":false},{"id":1587149,"name":"Angela Dettling","orcid":null,"position":4,"is_corresponding":false},{"id":2642,"name":"Paulus Kirchhof","orcid":"0000-0002-1881-0197","position":5,"is_corresponding":false},{"id":240632,"name":"Stefan Blankenberg","orcid":"0000-0001-6488-2362","position":6,"is_corresponding":false},{"id":614399,"name":"Christina Magnussen","orcid":"0000-0002-5102-0955","position":7,"is_corresponding":false},{"id":1017988,"name":"Benedikt Schrage","orcid":"0000-0001-9041-3922","position":8,"is_corresponding":false},{"id":1587143,"name":"Benedikt N. Beer","orcid":"0000-0003-4315-2533","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Prediction of Cardiac Worsening Through to Cardiogenic Shock in Patients with Acute Heart Failure","abstract":"<jats:title>Abstract</jats:title>\n                  <jats:sec>\n                    <jats:title>Aims</jats:title>\n                    <jats:p>Acute heart failure (AHF) can result in worsening of heart failure (WHF), cardiogenic shock (CS), or death. Risk factors for these adverse outcomes are not well characterized. This study aimed to identify predictors for WHF or new-onset CS in patients hospitalized for AHF.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results</jats:title>\n                    <jats:p>Prospective cohort study enrolling consecutive patients with AHF admitted to a large tertiary care centre with follow-up until death or discharge. WHF was defined by the RELAX-AHF-2 criteria. CS was defined as SCAI stages B–E. Potential predictors were assessed by fitting logistic regression models adjusted for age and sex. N = 233 patients were enrolled, median age was 78 years, and 80 were women (35.9%). Ischaemic cardiomyopathy was present in 82 patients (40.8%). Overall, 96 (44.2%) developed WHF and 18 (9.7%) CS. In-hospital death (8/223, 3.6%) was related to both events (WHF: OR 6.64, 95% CI 1.21–36.55, P = 0.03; CS: OR 38.27, 95% CI 6.32–231.81, P &amp;lt; 0.001). Chronic kidney disease (OR 2.20, 95% CI 1.25–3.93, P = 0.007), logarithmized serum creatinine (OR 2.90, 95% CI 1.51–5.82, P = 0.002), cystatin c (OR 1.86, 95% CI 1.27–2.77, P = 0.002), tricuspid valve regurgitation (OR 2.08, 95% CI 1.11–3.94, P = 0.023) and logarithmized pro-adrenomedullin (OR 3.01, 95% CI 1.75–5.38, P &amp;lt; 0.001) were significant predictors of WHF. Chronic kidney disease (OR 3.17, 95% CI 1.16–9.58, P = 0.03), cystatin c (OR 1.88, 95% CI 1.00–3.53, P = 0.045), logarithmized pro-adrenomedullin (OR 2.90, 95% CI 1.19–7.19, P = 0.019), and tricuspid valve regurgitation (OR 10.44, 95% CI 2.61–70.00, P = 0.003) were significantly with new-onset CS.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions</jats:title>\n                    <jats:p>Half of patients admitted with AHF experience WHF or new-onset CS. Chronic kidney disease, tricuspid valve regurgitation, and elevated pro-adrenomedullin concentrations predict these events. They could potentially serve as early warning signs for further deterioration in AHF patients.</jats:p>\n                  </jats:sec>","is_dataset_classified":null,"base_score":2.0794415416798357,"endowment":2.0794415416798357,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"38632837","pmcid":"PMC11287305","openalex_id":"https://openalex.org/W4394917785","authors":[],"funders":[{"funder_name":"Else Kröner-Fresenius-Stiftung","grant_id":"2019_A142","title":null},{"funder_name":"European Commission","grant_id":"965286","title":"Machine Learning Artificial Intelligence Early Detection Stroke Atrial Fibrillation"},{"funder_name":"European Commission","grant_id":"847770","title":"DIGITAL, RISK-BASED SCREENING FOR ATRIAL FIBRILLATION IN THE EUROPEAN COMMUNITY"}],"total_grants":3,"fwci":2.0737,"citation_percentile":0.88026437,"influential_citations":0,"citation_trend":[{"year":2024,"count":2},{"year":2025,"count":2},{"year":2026,"count":3}],"oa_status":"gold","license":"cc-by-nc-nd","oa_locations":[{"url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/ehf2.14792","host_type":"journal"},{"url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/ehf2.14792","host_type":"publisher"},{"url":"https://academic.oup.com/eschf/article-pdf/11/4/2249/64526901/eschf_11_4_2249.pdf","host_type":"publisher"},{"url":"https://doi.org/10.1002/ehf2.14792","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/38632837","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/11287305","host_type":"repository"},{"url":"https://research.birmingham.ac.uk/en/publications/91216064-a250-492e-a4b1-3254e53ea765","host_type":"repository"},{"url":"https://doaj.org/article/1837bd0544aa4634ace620d2c937bd42","host_type":"repository"},{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC11287305/pdf/EHF2-11-2249.pdf","host_type":"repository"},{"url":"https://pure-oai.bham.ac.uk/ws/files/224381079/ehf2.14792.pdf","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC11287305","host_type":"Europe_PMC"},{"url":"https://europepmc.org/articles/PMC11287305?pdf=render","host_type":"Europe_PMC"},{"url":"http://dx.doi.org/10.1002/ehf2.14792","host_type":""}],"fields_of_study":["Heart Failure Treatment and Management","Mechanical Circulatory Support Devices","Cardiac Structural Anomalies and Repair","03 medical and health sciences","0302 clinical medicine"],"mesh_terms":["Acute Disease","Aged","Aged, 80 and over","Female","Follow-Up Studies","Heart Failure","Humans","Male","Prognosis","Prospective Studies","Risk Factors","Shock, Cardiogenic","Biomarkers","Survival Rate","Hospital Mortality","Disease Progression"],"keywords":["Cardiogenic shock","Heart failure","Medicine","Cardiology","Internal medicine","Shock (circulatory)","Intensive care medicine","Myocardial infarction","Prediction","risk","Acute Heart Failure","Worsening Heart Failure","Pro‐adrenomedullin","Male","Shock, Cardiogenic","Risk Factors","Diseases of the circulatory (Cardiovascular) system","Humans","Prospective Studies","Hospital Mortality","Aged","Aged, 80 and over","Prognosis","Survival Rate","RC666-701","Acute Disease","Disease Progression","Original Article","Female","Biomarkers","Follow-Up Studies"],"sdg_mappings":[{"sdg_number":3,"sdg_label":"3. Good health"},{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-02T20:48:45.657663Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}