{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T09:07:17Z","timestamp":1783933637822,"version":"3.55.0"},"reference-count":35,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Introduction and objectives: Acute heart failure (AHF) is the leading cardiovascular cause of hospitalization and remains associated with high mortality and rehospitalization rates. Contemporary real-world data from cardiology departments are scarce. We aimed to identify admission characteristics associated with one-year outcomes in patients hospitalized with AHF. Methods: RECYLICA is a prospective, multicentre, regional registry including consecutive patients admitted with AHF to cardiology departments across 10 hospitals over a one-year period. Patients were followed for 12 months. The primary endpoint was the composite of all-cause mortality or heart failure (HF) rehospitalization. Results: A total of 602 patients were included (37.0% women; mean age 72.6 \u00b1 12.0 years), of whom 47.4% had heart failure with reduced left ventricular ejection fraction (HFrEF). During follow-up, 83 patients (13.8%) died and 105 (17.4%) were rehospitalized because of HF. Independent predictors of the primary endpoint were elevated admission N-terminal pro-B-type natriuretic peptide (NT-proBNP), atrial fibrillation (AF), chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), previous HF, prior implantable cardioverter-defibrillator (ICD) implantation, and higher left ventricular ejection fraction (LVEF). Among patients with HFrEF, less comprehensive implementation of guideline-directed medical therapy (GDMT) at discharge was associated with significantly worse outcomes. Conclusions: In patients hospitalized with AHF, prognosis is primarily determined by comorbidity burden, admission NT-proBNP levels, previous HF, and LVEF. Among patients with HFrEF, more comprehensive implementation of GDMT at discharge was associated with improved clinical outcomes, supporting early optimization of evidence-based therapy during hospitalization.<\/jats:p>","DOI":"10.3390\/jcdd13070310","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T14:56:42Z","timestamp":1783349802000},"page":"310","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic Factors of Acute Heart Failure: A Regional Population Registry"],"prefix":"10.3390","volume":"13","author":[{"given":"Juan","family":"Asensio-Nogueira","sequence":"first","affiliation":[{"name":"Department of Cardiology, Complejo Asistencial de Burgos, 09006 Burgos, Spain"},{"name":"Department of Cardiology, Hospital Cl\u00ednico Universitario de Valladolid, 47003 Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2244-1259","authenticated-orcid":false,"given":"Miguel","family":"Rodriguez-Santamarta","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Complejo Asistencial Universitario, 24008 Le\u00f3n, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Tobar-Ru\u00edz","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Cl\u00ednico Universitario de Valladolid, 47003 Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro Daniel","family":"Perdiguero-Mart\u00edn","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Nuestra Se\u00f1ora de Sonsoles, 05004 \u00c1vila, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4740-2958","authenticated-orcid":false,"given":"In\u00e9s","family":"Toranzo-Nieto","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Universitario de Salamanca, 37007 Salamanca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clea","family":"Gonz\u00e1lez-Maniega","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Complejo Asistencial Universitario, 24008 Le\u00f3n, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3951-129X","authenticated-orcid":false,"given":"Adri\u00e1n","family":"Lozano-Ib\u00e1\u00f1ez","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Cl\u00ednico Universitario de Valladolid, 47003 Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1829-2644","authenticated-orcid":false,"given":"Luc\u00eda","family":"Moreno-de-Redrojo Cortes","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Universitario de Salamanca, 37007 Salamanca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7282-2367","authenticated-orcid":false,"given":"Manuel","family":"Carrasco-Moraleja","sequence":"additional","affiliation":[{"name":"Department of Statistics, Hospital Cl\u00ednico Universitario de Valladolid, 47003 Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1lvaro","family":"Margalejo-Franco","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Complejo Asistencial de Burgos, 09006 Burgos, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Moreno-Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Hospital Virgen de la Concha, 49022 Zamora, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis Eduardo","family":"Enr\u00edquez-Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Santa B\u00e1rbara, 42005 Soria, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebasti\u00e1n","family":"Isaza-Arana","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital de Medina del Campo, 47400 Medina del Campo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3513-1193","authenticated-orcid":false,"given":"\u00c1lvaro","family":"Rold\u00e1n-Sevilla","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Complejo Asistencial de Burgos, 09006 Burgos, Spain"},{"name":"Cardiology Unit, Hospital Santos Reyes, 09006 Aranda de Duero, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3032-6995","authenticated-orcid":false,"given":"Williams Enrique","family":"Hinojosa-Camargo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Nuestra Se\u00f1ora de Sonsoles, 05004 \u00c1vila, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"\u00c1lvarez-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Universitario de Salamanca, 37007 Salamanca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Mart\u00edn-Paniagua","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Cl\u00ednico Universitario de Valladolid, 47003 Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1974-5243","authenticated-orcid":false,"given":"Mar\u00eda Jos\u00e9","family":"Ruiz-Olgado","sequence":"additional","affiliation":[{"name":"Hospital Virgen de la Concha, 49022 Zamora, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1451-1445","authenticated-orcid":false,"given":"Jose-Angel","family":"Perez-Rivera","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Complejo Asistencial de Burgos, 09006 Burgos, Spain"},{"name":"Facultad de Ciencias de la Salud, Universidad Isabel I, 09006 Burgos, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","article-title":"2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure","volume":"42","author":"McDonagh","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1002\/ehf2.12005","article-title":"Heart failure: Preventing disease and death worldwide","volume":"1","author":"Ponikowski","year":"2014","journal-title":"ESC Heart Fail."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"3272","DOI":"10.1093\/cvr\/cvac013","article-title":"Global burden of heart failure: A comprehensive and updated review of epidemiology","volume":"118","author":"Savarese","year":"2023","journal-title":"Cardiovasc. Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1002\/ejhf.566","article-title":"European Society of Cardiology Heart Failure Long-Term Registry (ESC-HF-LT): 1-year follow-up outcomes and differences across regions","volume":"18","author":"Anker","year":"2016","journal-title":"Eur. J. Heart Fail."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1242","DOI":"10.1002\/ejhf.890","article-title":"Clinical phenotypes and outcome of patients hospitalized for acute heart failure: The ESC Heart Failure Long-Term Registry","volume":"19","author":"Chioncel","year":"2017","journal-title":"Eur. J. Heart Fail."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1002\/ejhf.2408","article-title":"A comprehensive characterization of acute heart failure with preserved versus mildly reduced versus reduced ejection fraction\u2014Insights from the ESC-HFA EORP Heart Failure Long-Term Registry","volume":"24","author":"Benson","year":"2022","journal-title":"Eur. J. Heart Fail."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1482","DOI":"10.1161\/CIRCULATIONAHA.107.696906","article-title":"Influence of nonfatal hospitalization for heart failure on subsequent mortality in patients with chronic heart failure","volume":"116","author":"Solomon","year":"2007","journal-title":"Circulation"},{"key":"ref_8","first-page":"522","article-title":"The RICA-2 registry: Design and baseline characteristics of the first 1,000 patients","volume":"224","author":"Trullas","year":"2024","journal-title":"Rev. Clin. Esp."},{"key":"ref_9","first-page":"11","article-title":"Characteristics and clinical course of patients with acute heart failure and the therapeutic measures applied in Spanish emergency departments: Based on the EAHFE registry (Epidemiology of Acute Heart Failure in Emergency Departments)","volume":"27","author":"Llorens","year":"2015","journal-title":"Emergencias"},{"key":"ref_10","first-page":"671","article-title":"Paradox of obesity in heart failure: Results from the Spanish RICA Registry","volume":"137","author":"Trullas","year":"2011","journal-title":"Med. Clin."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.medcli.2018.05.012","article-title":"De novo acute heart failure: Clinical features and one-year mortality in the Spanish nationwide Registry of Acute Heart Failure","volume":"152","author":"Franco","year":"2019","journal-title":"Med. Clin."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2811","DOI":"10.1253\/circj.CJ-17-1386","article-title":"Demographics, Management, and In-Hospital Outcome of Hospitalized Acute Heart Failure Syndrome Patients in Contemporary Real Clinical Practice in Japan\u2014Observations From the Prospective, Multicenter Kyoto Congestive Heart Failure (KCHF) Registry","volume":"82","author":"Yaku","year":"2018","journal-title":"Circ. J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1253\/circj.CJ-18-0543","article-title":"Comparison of Characteristics and 3-Year Outcomes in Patients With Acute Heart Failure With Preserved, Mid-Range, and Reduced Ejection Fraction","volume":"83","author":"Cho","year":"2019","journal-title":"Circ. J."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Abid, L., Charfeddine, S., Kammoun, I., Ben Halima, M., Ben Slima, H., Drissa, M., Mzoughi, K., Mbarek, D., Riahi, L., and Antit, S. (2021). Epidemiology of heart failure and long-term follow-up outcomes in a north-African population: Results from the NAtional TUnisian REgistry of Heart Failure (NATURE-HF). PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0251658"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1056\/NEJMoa2107038","article-title":"Empagliflozin in Heart Failure with a Preserved Ejection Fraction","volume":"385","author":"Anker","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1056\/NEJMoa2206286","article-title":"Dapagliflozin in Heart Failure with Mildly Reduced or Preserved Ejection Fraction","volume":"387","author":"Solomon","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"4277","DOI":"10.1093\/eurheartj\/ehy626","article-title":"Prognostic implications of atrial fibrillation in heart failure with reduced, mid-range, and preserved ejection fraction: A report from 14 964 patients in the European Society of Cardiology Heart Failure Long-Term Registry","volume":"39","author":"Zafrir","year":"2018","journal-title":"Eur. Heart J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1002\/ejhf.964","article-title":"Characteristics, treatments and 1-year prognosis of hospitalized and ambulatory heart failure patients with chronic obstructive pulmonary disease in the European Society of Cardiology Heart Failure Long-Term Registry","volume":"20","author":"Canepa","year":"2018","journal-title":"Eur. J. Heart Fail."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1016\/j.diabres.2014.03.015","article-title":"Association between type-2 diabetes mellitus and post-discharge outcomes in heart failure patients: Findings from the RICA registry","volume":"104","author":"Formiga","year":"2014","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1780","DOI":"10.1161\/01.CIR.0000143059.68996.A7","article-title":"Prognostic impact of plasma N-terminal pro-brain natriuretic peptide in severe chronic congestive heart failure: A substudy of the Carvedilol Prospective Randomized Cumulative Survival (COPERNICUS) trial","volume":"110","author":"Hartmann","year":"2004","journal-title":"Circulation"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2168","DOI":"10.1161\/01.CIR.0000144310.04433.BE","article-title":"N-terminal-pro-brain natriuretic peptide predicts outcome after hospital discharge in heart failure patients","volume":"110","author":"Bettencourt","year":"2004","journal-title":"Circulation"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1186\/s43044-023-00342-9","article-title":"The predictive value of precipitating factors on clinical outcomes in hospitalized patients with decompensated heart failure: Insights from the Egyptian cohort in the European Society of Cardiology Heart Failure long-term registry","volume":"75","author":"Bendary","year":"2023","journal-title":"Egypt Heart J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1777","DOI":"10.1002\/ejhf.1800","article-title":"Readmission and death in patients admitted with new-onset versus worsening of chronic heart failure: Insights from a nationwide cohort","volume":"22","author":"Butt","year":"2020","journal-title":"Eur. J. Heart Fail."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2476","DOI":"10.1016\/j.jacc.2017.08.074","article-title":"Heart Failure With Preserved, Borderline, and Reduced Ejection Fraction: 5-Year Outcomes","volume":"70","author":"Shah","year":"2017","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1016\/j.jacc.2007.04.064","article-title":"Characteristics, treatments, and outcomes of patients with preserved systolic function hospitalized for heart failure: A report from the OPTIMIZE-HF Registry","volume":"50","author":"Fonarow","year":"2007","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_26","first-page":"13","article-title":"Causes of death in hospitalized patients in internal medicine departments with heart failure according to ejection fraction. RICA registry","volume":"158","author":"Manzano","year":"2022","journal-title":"Med. Clin."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1002\/ejhf.932","article-title":"Heart failure oral therapies at discharge are associated with better outcome in acute heart failure: A propensity-score matched study","volume":"20","author":"Gayat","year":"2018","journal-title":"Eur. J. Heart Fail."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jchf.2018.06.011","article-title":"Initiation, Continuation, Switching, and Withdrawal of Heart Failure Medical Therapies During Hospitalization","volume":"7","author":"Bhagat","year":"2019","journal-title":"JACC Heart Fail."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1002\/ejhf.289","article-title":"Recommendations on pre-hospital & early hospital management of acute heart failure: A consensus paper from the Heart Failure Association of the European Society of Cardiology, the European Society of Emergency Medicine and the Society of Academic Emergency Medicine","volume":"17","author":"Mebazaa","year":"2015","journal-title":"Eur. J. Heart Fail."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1056\/NEJMoa2030183","article-title":"Sotagliflozin in Patients with Diabetes and Recent Worsening Heart Failure","volume":"384","author":"Bhatt","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1056\/NEJMoa1812851","article-title":"Angiotensin-Neprilysin Inhibition in Acute Decompensated Heart Failure","volume":"380","author":"Velazquez","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1002\/ejhf.1498","article-title":"Initiation of sacubitril\/valsartan in haemodynamically stabilised heart failure patients in hospital or early after discharge: Primary results of the randomised TRANSITION study","volume":"21","author":"Wachter","year":"2019","journal-title":"Eur. J. Heart Fail."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1093\/eurheartj\/ehac530","article-title":"Impact of empagliflozin on decongestion in acute heart failure: The EMPULSE trial","volume":"44","author":"Biegus","year":"2023","journal-title":"Eur. Heart J."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1938","DOI":"10.1016\/S0140-6736(22)02076-1","article-title":"Safety, tolerability and efficacy of up-titration of guideline-directed medical therapies for acute heart failure (STRONG-HF): A multinational, open-label, randomised, trial","volume":"400","author":"Mebazaa","year":"2022","journal-title":"Lancet"},{"key":"ref_35","first-page":"347","article-title":"Prognostic Impact of Physician Specialty on the Prognosis of Outpatients With Heart Failure: Propensity Matched Analysis of the REDINSCOR and RICA Registries","volume":"70","author":"Puig","year":"2017","journal-title":"Rev. Esp. Cardiol."}],"container-title":["Journal of Cardiovascular Development and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2308-3425\/13\/7\/310\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T08:28:41Z","timestamp":1783931321000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2308-3425\/13\/7\/310"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,6]]},"references-count":35,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["jcdd13070310"],"URL":"https:\/\/doi.org\/10.3390\/jcdd13070310","relation":{},"ISSN":["2308-3425"],"issn-type":[{"value":"2308-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,6]]}}}