Akut dekompanse kalp yetersizliği ile hastanemize başvuran hastaların bir yıllık takibinde kardiyovasküler mortaliteyi gösteren belirteçler / The one year determinants of patients which show the cardiovascular mortality, who were hospitalized for acute decompense heart failure

Abstract

Aim: The presence of many blood count and biochemical parameters are known to show mortality in acute decompensated heart failure. In our study, we aimed to find the best markers showing mortality.Method: 176 patients hospitalized due to ADHF were enrolled. Treatment modalities and comorbidities influencing leukocyte counts were excluded.Hemogram, ProBNP, D-Dimer, cardiac troponins, biochemistry, sensitive C-reactive protein, urinanalysis and echocardiography were obtained. Cardiovascular deaths at the end of the first year were determined.Results: WBC and absolute neutrophil count were significantly higher and absolute lymphocyte and absolute eosinophil counts were significantly lower in the deceased patients than patients survived. Groups were similar in terms of monocyte counts. BMI, ferritin, uric acid, free T3 (FT3), D-dimer, ProBNP, ejection fraction (EF), albumin, systolic dysfunction, mitral regurgitation, hypotension, hyponatremia, acute renal failure were significantly different among dead and surviving patients. Logistic regression analysis employing these variables showed that low BMI, low albumin, low EF, hyponatremia, low absolute eosinophil count, and low FT3 as a whole were responsible from the 81.8% of cardiovascular deaths. Death rate among patients with an absolute eosinophil count of ?20/mm3 was 4.8 fold higher than the patients with an absolute eosinophil of >20/mm3.Conclusion: In our study, in ADHF, six levels associated with prognosis were worth significantly more than others: the EF Low, low BMI, hypoalbuminemia, free T3, hyponatremia, eosinopeni. Eosinopenin is thought to be due to increased sympatho-adrenarjik activty.