De Novo Acute Heart Failure Versus Acute Decompensated Chronic Heart Failure - Are There Differences in In-Hospital Outcomes and Mortality?

Q: What was the study’s main objective?

To evaluate differences in in-hospital complications and mortality between patients hospitalized with de novo acute heart failure (dn-AHF) and those with acute decompensated chronic heart failure (ad-CHF).

Q: How were patients classified in the study?

Patients hospitalized for acute HF were classified as dn-AHF or ad-CHF, and sociodemographic, clinical, and in-hospital outcomes were compared between the groups.

Q: Which group showed higher in-hospital mortality?

In-hospital mortality was higher in dn-AHF than in ad-CHF (9.8% vs 5.5%), and dn-AHF remained independently associated with greater in-hospital mortality after adjustment.

Sep 28, 2026

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Heart failure (HF) drives major global morbidity and mortality. Patients with acute decompensated chronic HF (adCHF) typically present with more comorbidities, whereas those with de novo acute HF (dn-AHF) may show a more severe clinical profile. Comparative evidence on in-hospital outcomes and mortality between dn-AHF and ad-CHF remains limited in Latin America. This study evaluates differences in complications and in-hospital mortality among dn-AHF versus ad-CHF hospitalizations in Colombia.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Abstract

Introduction

Materials and Methods

Results

Conclusions

Original Article Cardiol Res. 2025;16(6):507-517 De Novo Acute Heart Failure Versus Acute Decompensated Chronic Heart Failure: Are There Differences in In-Hospital Outcomes and Mortality? Juan David Pelaez-Martineza, Daniel Castilloa, Jackelin Maingueza, Sebastian Seni-Molinab, Yorlany Rodasb, Hoover O. Leon-Giraldoa, b, Diana Cristina Carrilloa, b, c, Juan David Lopez-Ponce de Leona, b, c, Noel Alberto Floreza, c, Pastor Olayaa, c, Edilma Lucy Riverac, Nancy Olayac, Juan Esteban Gomez-Mesaa, b, c, d Abstract Background: Heart failure (HF) is a major cause of global morbidity and mortality. Patients with acute decompensated chronic HF (adCHF) usually have more comorbidities, whereas those with de novo acute HF (dn-AHF) may have a more severe clinical presentation. Despite extensive research on HF, comparative data on in-hospital outcomes and mortality between these groups are scarce in Latin American countries. The aim of this study was to evaluate differences in in-hospital complications and mortality among patients hospitalized with either dn-AHF or ad-CHF. Methods: An ambispective study was conducted at a tertiary hospital in Colombia, including 780 patients hospitalized for acute HF. Patients were classified as dn-AHF or ad-CHF, and sociodemographic, clinical, and in-hospital outcomes were compared using bivariate analysis. A Firth penalized logistic regression model was used to assess the association between dn-AHF and in-hospital mortality. Results: Of these patients, 39.2% had dn-AHF, and 60.8% had adCHF. Median ages were 67 (interquartile range (IQR): 56-76) and 66 (IQR: 55-79) years, respectively. Both groups had a predominance of reduced left ventricular ejection fraction, with median values of 30% in ad-CHF and 34% in dn-AHF. Ad-CHF patients had more comorbidities, whereas dn-AHF patients showed higher rates of cardiac and non-cardiac complications. Intensive care unit (ICU) admission rates were similar, the need for invasive mechanical ventilation (P Manuscript submitted August 19, 2025, accepted October 25, 2025 Published online December 20, 2025 aFacultad de Ciencias de la Salud, Universidad Icesi, Cali 760008, Colombia bCentro de Investigaciones Clinicas (CIC), Fundacion Valle del Lili, Cali 760031, Colombia cServicio de Cardiologia, Fundacion Valle del Lili, Cali 760031, Colombia dCorresponding Author: Juan Esteban Gomez-Mesa, Servicio de Cardiologia, Fundacion Valle del Lili, Cali 760031, Colombia. Email: [juan.gomez.me@fvl.org.co](juan.gomez.me@fvl.org.co) doi: [https://doi.org/10.14740/cr2135](https://doi.org/10.14740/cr2135) < 0.001) and the occurrence of infections (P = 0.049) were significantly more frequent in patients with dn-AHF. In-hospital mortality was higher in dn-AHF than ad-CHF (9.8% vs. 5.5%, P = 0.023). After adjustment, dn-AHF remained independently associated with greater in-hospital mortality (odds ratio (OR): 1.87; 95% confidence interval (CI): 1.07-3.31; P = 0.029) . Conclusions: Patients with dn-AHF experienced more in-hospital complications and higher mortality than those with ad-CHF, despite similar ICU admission rates and fewer comorbidities. These results highlight the prognostic importance of dn-AHF and underscore the need for early identification, vigilant monitoring, and phenotype-specific management from admission to improve outcomes, particularly among patients with reduced ejection fraction. Keywords: Acute decompensated chronic heart failure; De novo acute heart failure; In-hospital mortality; Complications Introduction Heart failure (HF) is a significant global health problem, affecting more than 64 million individuals worldwide [1] . Despite advancements in pharmacotherapy, its mortality rate remains high, reaching 6.7-17.9% at discharge and 10.9% at 30 days in the Latin American context [2-4] . Data from the Rochester Epidemiology Project, a population-based registry in Minnesota, USA, revealed that patients with a history of HFare rehos

FAQs

What was the study’s main objective?

To evaluate differences in in-hospital complications and mortality between patients hospitalized with de novo acute heart failure (dn-AHF) and those with acute decompensated chronic heart failure (ad-CHF).

How were patients classified in the study?

Patients hospitalized for acute HF were classified as dn-AHF or ad-CHF, and sociodemographic, clinical, and in-hospital outcomes were compared between the groups.

Which group showed higher in-hospital mortality?

In-hospital mortality was higher in dn-AHF than in ad-CHF (9.8% vs 5.5%), and dn-AHF remained independently associated with greater in-hospital mortality after adjustment.

Sep 28, 2026

Uploaded by Well Done