IJCS | Volume 33, Nº1, January / February 2019

49 class VI, there were no statistical differences between the categories of HF. With regard to the laboratory variables, the groups were distinct in terms of natriuretic peptides (NT- ProBNP) levels and anaemia, which were higher among patients with HFrEF and HFmrEF. LV end-diastolic diameter (LVEDD) values were higher among HFrEF patients compared toHFpEF patients. Moderate to severe mitral regurgitation (MR) was commonly observed in HFrEF and HFmrEF. In-hospital pharmacological treatment of patients with DHF is presented in Chart 1. Beta-blockers, ACEi/ ARB and Spironolactone were used in 78%, 69% and 53% of HFrEF patients, respectively. However, statistical significance was only observed in the Spironolactone variable, which is more commonly used in patients with HFrEF. No statistical difference was observed between the groups in terms of in-hospital death and readmission within 30 days. According to the bivariate analysis, the variables that presented a significant association with in-hospital death for patients with HFrEF were: advanced age, valve disease, kidney disease, peripheral vascular disease (PVD), urea, aneamia, beta-blocker and ACEi/ARB; for Chart 1 - Sample distribution, according to the drug administered during hospitalization. HFmrEF: kidney disease, urea at admission, aneamia and beta-blocker; and for HFpEF: kidney disease, PVD and creatinine at admission. The independent risk factors obtained bymultivariate analysis for in-hospital death are shown in Table 2. In the worst outcomes, previous kidney disease was associated with HFrEF and HFpEF. Previous valve disease was related to HFmrEF and HFpEF, and increased urea levels, exclusively in HFmrEF. The use of medication, such as beta-blockers and ACEi/ARB, were associated with a better evolution in HFmrEF and HFrEF, respectively. It is worthy to highlight that HFrEF was associated with higher in-hospital mortality rates in patients with previous kidney disease (Odds Ratio (OR): 2.84, CI:1.19- 6.79) and showed a 3.5 higher risk of in-hospital death for patients under no beta-blocker therapy and an almost 5 times higher risk for those under no treatment withACE inhibitors or ARBs. HFmrEF was associated with higher in-hospital mortality rates for valve disease (OR: 4.17, CI: 1.01-9.13) and to altered levels of urea at admission (OR:6.18, CI:1.78-11.45), and the likelihood of death increased by 3.5 times in patients under no beta-blocker therapy. In relation to HFpEF patients, there was an Cavalcanti et al. Decompensated heart failure with intermediate ejection fraction Int J Cardiovasc Sci. 2020;33(1):45-54 Original Article