• Guo-Gan Wang, Si-Jia Wang, Jian Qin, Chun-Sheng Li, Xue-Zhong Yu, Hong Shen, Li-Pei Yang, Yan Fu, Ya-An Zheng, Bin Zhao, Dong-Min Yu, Fu-Jun Qin, De-Gui Zhou, Ying Li, Fu-Jun Liu, Wei Li, Wei Zhao, Xin Gao, Zheng Wang, Ming Jin, Hong Zeng, Yi Li, Guo-Xing Wang, Hong Zhou, Xiao-Lu Sun, Peng-Bo Wang, and Kam-Sang Woo.
• Emergency and Critical Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
• Chin. Med. J. 2017 Aug 20; 130 (16): 189419011894-1901.

BackgroundThe emergency department (ED) has a pivotal influence on the management of acute heart failure (AHF), but data concerning current ED management are scarce. This Beijing AHF Registry Study investigated the characteristics, ED management, and short- and long-term clinical outcomes of AHF.MethodsThis prospective, multicenter, observational study consecutively enrolled 3335 AHF patients who visited 14 EDs in Beijing from January 1, 2011, to September 23, 2012. Baseline data on characteristics and management were collected in the EDs. Follow-up data on death and readmissions were collected until November 31, 2013, with a response rate of 92.80%. The data were reported as median (interquartile range) for the continuous variables, or as number (percentage) for the categorical variables.ResultsThe median age of the enrolled patients was 71 (58-79) years, and 46.84% were women. In patients with AHF, coronary heart disease (43.27%) was the most common etiology, and myocardium ischemia (30.22%) was the main precipitant. Most of the patients in the ED received intravenous treatments, including diuretics (79.28%) and vasodilators (74.90%). Fewer patients in the ED received neurohormonal antagonists, and 25.94%, 31.12%, and 33.73% of patients received angiotensin converting enzyme inhibitors/angiotensin receptor blockers, beta-blockers, and spironolactone, respectively. The proportions of patients who were admitted, discharged, left against medical advice, and died were 55.53%, 33.58%, 7.08%, and 3.81%, respectively. All-cause mortalities at 30 days and 1 year were 15.30% and 32.27%, respectively.ConclusionsSubstantial details on characteristics and ED management of AHF were investigated. The clinical outcomes of AHF patients were dismal. Thus, further investigations of ED-based therapeutic approaches for AHF are needed.

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