Prognostic models and biomarkers in patients with acute decompensated heart failure admitted to ward

Heart Failure (HF) accounts for 1-3% of all US and European hospital
admissions. Patients admitted with acute decompensated HF (ADHF) have poor
short- and long-term prognosis, after discharge * 20% of patients are
readmitted within 30 days and up to 50% by 6 months. A reduction in HF
readmissions simultaneously improves the quality of care and reduces costs. To
reduce HF readmission rates a comprehensive characterization of predictors of
readmission in patients with HF is imperative. Multivariable risk scores can
predict risk for adverse events such as readmission or mortality in patients
admitted with ADHF. High risk patients can be targeted for intervention or
indicate incomplete treatment in hospital. The ELAN-HF score is a novel, simple
and yet robust discharge risk score developed by Salah et. al that incorporates
natriuretic peptide levels in addition to known risk markers to predict adverse
events. Next to natriuretic peptide levels, other biomarkers have emerged that
allow prognostication of patients admitted with ADHF. Recent studies have shown
that combining multiple biomarkers in a multimarker panel, substantially
improves prediction of adverse events beyond current metrics.

Since the ELAN-HF score has only been externally validated in one cohort, the
primary objective of this study is to perform an external validation of the
ELAN-HF score in a cohort of patients admitted with ADHF at the Catharina
Hospital. A second primary objective is to serially measure a multimarker panel
in this cohort and combine these measurements with clinical data from multiple
sources (e.g. prescribed medication, medical history, physiological
measurements etc.) to capture the heterogeneous nature of HF in a novel
discharge risk score.

This study is a prospective, non-randomized, observational, single-center
cohort study.

There are minimal risks associated with participation in this study, most
measurements performed during this study are part of routine care. The
additional burden is presented in the form of extra vials of blood that need to
be withdrawn on admission, discharge and one week of discharge, attachment of a
watch that registers PPG signals (in a subgroup of patients), and three moments
in time where a questionnaire has to be filled in.