Advanced Heart Failure Epidemiology and Outcomes: A Population-Based Study
OBJECTIVESThe goal of this study was to evaluate the prevalence, characteristics, and outcomes of patients with advanced heart failure (HF) in a geographically defined population. BACKGROUNDSome patients with HF progress to advanced HF, characterized by debilitating HF symptoms refractory to therapy...
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| Veröffentlicht in: | JACC. Heart failure 2021-10, Vol.9 (10), p.722-732 |
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| container_title | JACC. Heart failure |
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| creator | Dunlay, Shannon M Roger, Véronique L Killian, Jill M Weston, Susan A Schulte, Philip J Subramaniam, Anna V Blecker, Saul B Redfield, Margaret M |
| description | OBJECTIVESThe goal of this study was to evaluate the prevalence, characteristics, and outcomes of patients with advanced heart failure (HF) in a geographically defined population. BACKGROUNDSome patients with HF progress to advanced HF, characterized by debilitating HF symptoms refractory to therapy. Limited data are available on the epidemiology and outcomes of patients with advanced HF. METHODSThis was a population-based cohort study of all Olmsted County, Minnesota, adults with and without HF from 2007 to 2017. The 2018 European Society of Cardiology advanced HF diagnostic criteria were operationalized and applied to all patients with HF. Hospitalization and mortality in advanced HF, overall and according to ejection fraction (EF) type (reduced EF |
| doi_str_mv | 10.1016/j.jchf.2021.05.009 |
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BACKGROUNDSome patients with HF progress to advanced HF, characterized by debilitating HF symptoms refractory to therapy. Limited data are available on the epidemiology and outcomes of patients with advanced HF. METHODSThis was a population-based cohort study of all Olmsted County, Minnesota, adults with and without HF from 2007 to 2017. The 2018 European Society of Cardiology advanced HF diagnostic criteria were operationalized and applied to all patients with HF. Hospitalization and mortality in advanced HF, overall and according to ejection fraction (EF) type (reduced EF <40% [HFrEF], mid-range EF 40%-49% [HFmrEF], and preserved EF ≥50% [HFpEF]) were examined using Andersen-Gill and Cox models. RESULTSOf 6,836 adults with HF, 936 (13.7%) met criteria for advanced HF. The prevalence of advanced HF increased with age and was higher in men. At advanced HF diagnosis, 396 (42.3%) patients had HFrEF, 134 (14.3%) had HFmrEF, and 406 (43.4%) had HFpEF. The median (interquartile range) time from advanced HF diagnosis to death was 12.2 months (3.7-29.9 months). The mean rate of hospitalization was 2.91 (95% CI: 2.78-3.06) per person-year in the first year after advanced HF diagnosis. There were no differences in risks of all-cause mortality or hospitalization by EF. Patients with advanced HFpEF were at lower risk for cardiovascular mortality compared with advanced HFrEF (HR: 0.79; 95% CI: 0.65-0.97). CONCLUSIONSIn this population-based study, more than one-half of patients with advanced HF had mid-range or preserved EF, and survival was poor regardless of EF.</description><identifier>ISSN: 2213-1779</identifier><identifier>EISSN: 2213-1787</identifier><identifier>DOI: 10.1016/j.jchf.2021.05.009</identifier><identifier>PMID: 34391736</identifier><language>eng</language><ispartof>JACC. Heart failure, 2021-10, Vol.9 (10), p.722-732</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids></links><search><creatorcontrib>Dunlay, Shannon M</creatorcontrib><creatorcontrib>Roger, Véronique L</creatorcontrib><creatorcontrib>Killian, Jill M</creatorcontrib><creatorcontrib>Weston, Susan A</creatorcontrib><creatorcontrib>Schulte, Philip J</creatorcontrib><creatorcontrib>Subramaniam, Anna V</creatorcontrib><creatorcontrib>Blecker, Saul B</creatorcontrib><creatorcontrib>Redfield, Margaret M</creatorcontrib><title>Advanced Heart Failure Epidemiology and Outcomes: A Population-Based Study</title><title>JACC. Heart failure</title><description>OBJECTIVESThe goal of this study was to evaluate the prevalence, characteristics, and outcomes of patients with advanced heart failure (HF) in a geographically defined population. BACKGROUNDSome patients with HF progress to advanced HF, characterized by debilitating HF symptoms refractory to therapy. Limited data are available on the epidemiology and outcomes of patients with advanced HF. METHODSThis was a population-based cohort study of all Olmsted County, Minnesota, adults with and without HF from 2007 to 2017. The 2018 European Society of Cardiology advanced HF diagnostic criteria were operationalized and applied to all patients with HF. Hospitalization and mortality in advanced HF, overall and according to ejection fraction (EF) type (reduced EF <40% [HFrEF], mid-range EF 40%-49% [HFmrEF], and preserved EF ≥50% [HFpEF]) were examined using Andersen-Gill and Cox models. RESULTSOf 6,836 adults with HF, 936 (13.7%) met criteria for advanced HF. The prevalence of advanced HF increased with age and was higher in men. At advanced HF diagnosis, 396 (42.3%) patients had HFrEF, 134 (14.3%) had HFmrEF, and 406 (43.4%) had HFpEF. The median (interquartile range) time from advanced HF diagnosis to death was 12.2 months (3.7-29.9 months). The mean rate of hospitalization was 2.91 (95% CI: 2.78-3.06) per person-year in the first year after advanced HF diagnosis. There were no differences in risks of all-cause mortality or hospitalization by EF. Patients with advanced HFpEF were at lower risk for cardiovascular mortality compared with advanced HFrEF (HR: 0.79; 95% CI: 0.65-0.97). CONCLUSIONSIn this population-based study, more than one-half of patients with advanced HF had mid-range or preserved EF, and survival was poor regardless of EF.</description><issn>2213-1779</issn><issn>2213-1787</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNpVkE1Lw0AYhBdRbKn9A55y9JK4H9nsxoNQxfpBoYJ6Dm9337RbkmzMJoX-ewMWwbnMwDDPYQi5ZjRhlGW3-2RvdmXCKWcJlQml-RmZcs5EzJRW539Z5RMyD2FPR2nJtNaXZCJSkTMlsil5W9gDNAZt9ILQ9dESXDV0GD21zmLtfOW3xwgaG62H3vgaw120iN59O1TQO9_EDxDG7Uc_2OMVuSihCjg_-Yx8LZ8-H1_i1fr59XGxilueij6W3FjMUkSljEa0msmcQwk2s6WiIi2lsamBjVFgJebaZJbaUgqKqhTKGjEj97_cdtjUaA02fQdV0Xauhu5YeHDF_6Zxu2LrD4VOtcpZNgJuToDOfw8Y-qJ2wWBVQYN-CAWXGRvv4eNLP1IJbN0</recordid><startdate>20211001</startdate><enddate>20211001</enddate><creator>Dunlay, Shannon M</creator><creator>Roger, Véronique L</creator><creator>Killian, Jill M</creator><creator>Weston, Susan A</creator><creator>Schulte, Philip J</creator><creator>Subramaniam, Anna V</creator><creator>Blecker, Saul B</creator><creator>Redfield, Margaret M</creator><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20211001</creationdate><title>Advanced Heart Failure Epidemiology and Outcomes: A Population-Based Study</title><author>Dunlay, Shannon M ; Roger, Véronique L ; Killian, Jill M ; Weston, Susan A ; Schulte, Philip J ; Subramaniam, Anna V ; Blecker, Saul B ; Redfield, Margaret M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p243t-52cde64ee77c8eed81592afad6df7034f5cd4cabc7ad5e98c6d0df530e7f37dc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dunlay, Shannon M</creatorcontrib><creatorcontrib>Roger, Véronique L</creatorcontrib><creatorcontrib>Killian, Jill M</creatorcontrib><creatorcontrib>Weston, Susan A</creatorcontrib><creatorcontrib>Schulte, Philip J</creatorcontrib><creatorcontrib>Subramaniam, Anna V</creatorcontrib><creatorcontrib>Blecker, Saul B</creatorcontrib><creatorcontrib>Redfield, Margaret M</creatorcontrib><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>JACC. Heart failure</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dunlay, Shannon M</au><au>Roger, Véronique L</au><au>Killian, Jill M</au><au>Weston, Susan A</au><au>Schulte, Philip J</au><au>Subramaniam, Anna V</au><au>Blecker, Saul B</au><au>Redfield, Margaret M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Advanced Heart Failure Epidemiology and Outcomes: A Population-Based Study</atitle><jtitle>JACC. Heart failure</jtitle><date>2021-10-01</date><risdate>2021</risdate><volume>9</volume><issue>10</issue><spage>722</spage><epage>732</epage><pages>722-732</pages><issn>2213-1779</issn><eissn>2213-1787</eissn><abstract>OBJECTIVESThe goal of this study was to evaluate the prevalence, characteristics, and outcomes of patients with advanced heart failure (HF) in a geographically defined population. BACKGROUNDSome patients with HF progress to advanced HF, characterized by debilitating HF symptoms refractory to therapy. Limited data are available on the epidemiology and outcomes of patients with advanced HF. METHODSThis was a population-based cohort study of all Olmsted County, Minnesota, adults with and without HF from 2007 to 2017. The 2018 European Society of Cardiology advanced HF diagnostic criteria were operationalized and applied to all patients with HF. Hospitalization and mortality in advanced HF, overall and according to ejection fraction (EF) type (reduced EF <40% [HFrEF], mid-range EF 40%-49% [HFmrEF], and preserved EF ≥50% [HFpEF]) were examined using Andersen-Gill and Cox models. RESULTSOf 6,836 adults with HF, 936 (13.7%) met criteria for advanced HF. The prevalence of advanced HF increased with age and was higher in men. At advanced HF diagnosis, 396 (42.3%) patients had HFrEF, 134 (14.3%) had HFmrEF, and 406 (43.4%) had HFpEF. The median (interquartile range) time from advanced HF diagnosis to death was 12.2 months (3.7-29.9 months). The mean rate of hospitalization was 2.91 (95% CI: 2.78-3.06) per person-year in the first year after advanced HF diagnosis. There were no differences in risks of all-cause mortality or hospitalization by EF. Patients with advanced HFpEF were at lower risk for cardiovascular mortality compared with advanced HFrEF (HR: 0.79; 95% CI: 0.65-0.97). CONCLUSIONSIn this population-based study, more than one-half of patients with advanced HF had mid-range or preserved EF, and survival was poor regardless of EF.</abstract><pmid>34391736</pmid><doi>10.1016/j.jchf.2021.05.009</doi><tpages>11</tpages></addata></record> |
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| source | EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| title | Advanced Heart Failure Epidemiology and Outcomes: A Population-Based Study |
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