Precipitants of Acute Heart Failure: A State-of-the-art Review from an International Expert Group
Abstract
Acute heart failure (AHF) is a leading cause of hospitalisation worldwide, with the majority of cases triggered by an identifiable precipitant. Recognition of these precipitants is important for both acute management and long-term prevention, as they are frequently reversible, carry prognostic significance and directly inform targeted therapy. The epidemiology of precipitants varies across settings, and patterns are evolving as the prevalence of heart failure with preserved ejection fraction rises. In this review, we summarise the epidemiology, diagnostic evaluation and management of the most common precipitants of AHF. Globally, the leading precipitants of AHF are ischaemia/acute coronary syndrome, infection, arrhythmias, uncontrolled hypertension, nonadherence and renal dysfunction, although their relative distribution varies by geography and heart failure phenotype. Optimal medical management necessitates initial haemodynamic stabilisation, identification of the underlying precipitant and delivery of targeted therapy. Importantly, successful identification and treatment of a reversible precipitant should not preclude initiation or optimisation of guideline-directed medical therapy, which remain essential for long-term outcomes.
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BibTeX
@article{naidu2026precipitants,
title = {{Precipitants of Acute Heart Failure: A State-of-the-art Review from an International Expert Group}},
author = {Anika S Naidu and Ovidiu Chioncel and Jolie Bruno and Javed Butler and Andrew Js Coats and Sean P Collins and Gad Cotter and Beth Davison and Zara Fatima and Oliviana Geavlete and Nicolas Girerd and Shir Lynn Lim and Alexandre Mebazaa and Marco Metra and Òscar Miró and Alberto Palazzuoli and Marija Polovina and Razvan I Raduc and Gianluigi Savarese and Dana R Sax and Petar M Seferovic and Maurizio Volterrani and Andrew P Ambrosy},
journal = {Cardiac Failure Review},
year = {2026},
month = aug,
doi = {10.15420/cfr.2025.49},
url = {https://hal.univ-lorraine.fr/hal-05752055v1},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Precipitants of Acute Heart Failure: A State-of-the-art Review from an International Expert Group
AU - Anika S Naidu
AU - Ovidiu Chioncel
AU - Jolie Bruno
AU - Javed Butler
AU - Andrew Js Coats
AU - Sean P Collins
AU - Gad Cotter
AU - Beth Davison
AU - Zara Fatima
AU - Oliviana Geavlete
AU - Nicolas Girerd
AU - Shir Lynn Lim
AU - Alexandre Mebazaa
AU - Marco Metra
AU - Òscar Miró
AU - Alberto Palazzuoli
AU - Marija Polovina
AU - Razvan I Raduc
AU - Gianluigi Savarese
AU - Dana R Sax
AU - Petar M Seferovic
AU - Maurizio Volterrani
AU - Andrew P Ambrosy
PY - 2026
DA - 2026/08/21
JO - Cardiac Failure Review
DO - 10.15420/cfr.2025.49
UR - https://hal.univ-lorraine.fr/hal-05752055v1
AB - Acute heart failure (AHF) is a leading cause of hospitalisation worldwide, with the majority of cases triggered by an identifiable precipitant. Recognition of these precipitants is important for both acute management and long-term prevention, as they are frequently reversible, carry prognostic significance and directly inform targeted therapy. The epidemiology of precipitants varies across settings, and patterns are evolving as the prevalence of heart failure with preserved ejection fraction rises. In this review, we summarise the epidemiology, diagnostic evaluation and management of the most common precipitants of AHF. Globally, the leading precipitants of AHF are ischaemia/acute coronary syndrome, infection, arrhythmias, uncontrolled hypertension, nonadherence and renal dysfunction, although their relative distribution varies by geography and heart failure phenotype. Optimal medical management necessitates initial haemodynamic stabilisation, identification of the underlying precipitant and delivery of targeted therapy. Importantly, successful identification and treatment of a reversible precipitant should not preclude initiation or optimisation of guideline-directed medical therapy, which remain essential for long-term outcomes.
SN - 2057-7559
SN - 2057-7540
ER -