Prevalence and prognostic significance of heart failure stages : Application of the american college of cardiology/american heart association heart failure staging criteria in the community

Heart failure (HF) is a progressive disorder associated with frequent morbidity and mortality. An American Heart Association/American College of Cardiology staging classification of HF has been developed to emphasize early detection and prevention. The prevalence of HF stages and their association w...

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Veröffentlicht in:Circulation (New York, N.Y.) N.Y.), 2007-03, Vol.115 (12), p.1563-1570
Hauptverfasser: AFZAL AMMAR, Khawaja, JACOBSEN, Steven J, MAHONEY, Douglas W, KORS, Jan A, REDFIELD, Margaret M, BURNETT, John C, RODEHEFFER, Richard J
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container_end_page 1570
container_issue 12
container_start_page 1563
container_title Circulation (New York, N.Y.)
container_volume 115
creator AFZAL AMMAR, Khawaja
JACOBSEN, Steven J
MAHONEY, Douglas W
KORS, Jan A
REDFIELD, Margaret M
BURNETT, John C
RODEHEFFER, Richard J
description Heart failure (HF) is a progressive disorder associated with frequent morbidity and mortality. An American Heart Association/American College of Cardiology staging classification of HF has been developed to emphasize early detection and prevention. The prevalence of HF stages and their association with mortality are unknown. We sought to estimate HF stage prevalence in the community and to measure the association of HF stages with mortality. A population-based, cross-sectional, random sample of 2029 Olmsted County, Minnesota, residents aged > or = 45 years was identified. Participants were classified by medical record review, symptom questionnaire, physical examination, and echocardiogram as follows: stage 0, healthy; stage A, HF risk factors; stage B, asymptomatic cardiac structural or functional abnormalities; stage C, HF symptoms; and stage D, severe HF. In the cohort, 32% were stage 0, 22% stage A, 34% stage B, 12% stage C, and 0.2% stage D. Mean B-type natriuretic peptide concentrations (in pg/mL) increased by stages: stage 0=26, stage A=32, stage B=53, stage C=137, and stage D=353. Survival at 5 years was 99% in stage 0, 97% in stage A, 96% in stage B, 75% in stage C, and 20% in stage D. The present study provides prevalence estimates and prognostic validation for HF staging in a community cohort. Of note, 56% of adults > or = 45 years of age were classified as being in stage A (risk factors) or B (asymptomatic ventricular dysfunction). HF staging underscores the magnitude of the population at risk for progression to overt HF.
doi_str_mv 10.1161/CIRCULATIONAHA.106.666818
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An American Heart Association/American College of Cardiology staging classification of HF has been developed to emphasize early detection and prevention. The prevalence of HF stages and their association with mortality are unknown. We sought to estimate HF stage prevalence in the community and to measure the association of HF stages with mortality. A population-based, cross-sectional, random sample of 2029 Olmsted County, Minnesota, residents aged &gt; or = 45 years was identified. Participants were classified by medical record review, symptom questionnaire, physical examination, and echocardiogram as follows: stage 0, healthy; stage A, HF risk factors; stage B, asymptomatic cardiac structural or functional abnormalities; stage C, HF symptoms; and stage D, severe HF. In the cohort, 32% were stage 0, 22% stage A, 34% stage B, 12% stage C, and 0.2% stage D. 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An American Heart Association/American College of Cardiology staging classification of HF has been developed to emphasize early detection and prevention. The prevalence of HF stages and their association with mortality are unknown. We sought to estimate HF stage prevalence in the community and to measure the association of HF stages with mortality. A population-based, cross-sectional, random sample of 2029 Olmsted County, Minnesota, residents aged &gt; or = 45 years was identified. Participants were classified by medical record review, symptom questionnaire, physical examination, and echocardiogram as follows: stage 0, healthy; stage A, HF risk factors; stage B, asymptomatic cardiac structural or functional abnormalities; stage C, HF symptoms; and stage D, severe HF. In the cohort, 32% were stage 0, 22% stage A, 34% stage B, 12% stage C, and 0.2% stage D. 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source MEDLINE; American Heart Association; Journals@Ovid Complete; EZB-FREE-00999 freely available EZB journals
subjects Aged
Aged, 80 and over
Biological and medical sciences
Blood and lymphatic vessels
Brain
Cardiology. Vascular system
Cohort Studies
Cross-Sectional Studies
Disease Progression
Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous
Dyspnea - epidemiology
Fatigue - epidemiology
Female
Health participants
Heart Failure - blood
Heart Failure - classification
Heart Failure - diagnostic imaging
Heart Failure - epidemiology
Heart Failure - etiology
Humans
Hypertrophy, Left Ventricular - complications
Hypertrophy, Left Ventricular - epidemiology
Investigative techniques of hemodynamics
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical sciences
Middle Aged
Minnesota - epidemiology
Myocardial Infarction - complications
Myocardial Infarction - epidemiology
Natriuretic Peptide, Brain - blood
Prevalence
Prognosis
Proportional Hazards Models
Prospective Studies
Public health. Hygiene
Public health. Hygiene-occupational medicine
Sampling Studies
Severity of Illness Index
Survival Analysis
Ultrasonography
title Prevalence and prognostic significance of heart failure stages : Application of the american college of cardiology/american heart association heart failure staging criteria in the community
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