Long-Term Trends in the Incidence of and Survival with Heart Failure

Levy, Daniel; Kenchaiah, Satish; Larson, Martin G.; Benjamin, Emelia J.; Kupka, Michelle J.; Ho, Kalon K.L.; Murabito, Joanne M.; Vasan, Ramachandran S.

doi:10.1056/nejmoa020265

Cited by 1,923 publications

(1,352 citation statements)

References 34 publications

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“…Previous national studies revealed a decline in all‐cause mortality,12, 22 and a similar pattern was noted internationally 10. However, there was no statistically significant change in trend in our study.…”

Section: Discussionsupporting

confidence: 86%

Outcomes following heart failure hospitalization in a regional Australian setting between 2005 and 2014

et al. 2017

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AimsThe aim of the current study is to examine 10 year trends in mortality and readmission following heart failure (HF) hospitalization in metropolitan and regional Australian settings.Methods and resultsWe identified all index HF hospitalizations in the Hunter New England region from 2005 to 2014, using a 10 year ‘look back’ period. The primary endpoint was a composite of all‐cause mortality or all‐cause readmission at 1 year. Secondary endpoints included all‐cause mortality, all‐cause readmission, and HF readmission at 30 days and 1 year. We used logistic regression to explore the predictors of the composite outcome of either all‐cause death or readmission at 1 year. There were 12 114 patients admitted with a first episode of HF between 2005 and 2014, followed up until death or the end of 2015. The mean age was 78 ± 12 years and 49% (n = 5906) were male. A total of 4831 (40%) resided in regional areas and the remainder in metropolitan areas. One hundred sixty‐eight patients (1.4%) were Aboriginal. Approximately 69% of patients had either died or been readmitted for any cause within 12 months of their index event. The 30 day and 1 year all‐cause mortality rates were 13% and 32%, respectively, with no change in the trend over the study period. Age, socio‐economic disadvantage, ischaemic heart disease, renal failure, and chronic lower respiratory disease were predictors of the primary endpoint.ConclusionsHeart failure hospitalizations are followed by high rates of death or readmission. There was no change in this composite endpoint over the 10 year study period.

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Section: Discussionsupporting

confidence: 86%

Outcomes following heart failure hospitalization in a regional Australian setting between 2005 and 2014

et al. 2017

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“…There was a striking increase in its prevalence from the 1970s through the 1990s, during which time it reached an epidemic level 3, 4. Although recent reports suggest that the incidence of HF has plateaued in the general population and is decreasing in some groups,1, 5, 6 an estimated 915 000 individuals are still diagnosed as having HF in the United States each year. Furthermore, because of the aging of the population and improved survival after diagnosis, the prevalence of HF is still increasing and is estimated to increase by 46% from 2012 to 2030, which will result in >8 million adults with a diagnosis of HF 2, 7…”

Section: Introductionmentioning

confidence: 99%

National Trends in Admission and In‐Hospital Mortality of Patients With Heart Failure in the United States (2001–2014)

Akintoye

Briasoulis

Egbe

et al. 2017

JAHA

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BackgroundTo investigate heart failure (HF) hospitalization trends in the United States and change in trends after publication of management guidelines.Methods and ResultsUsing data from the National Inpatient Sample and the US Census Bureau, annual national estimates in HF admissions and in‐hospital mortality were estimated for years 2001 to 2014, during which an estimated 57.4 million HF‐associated admissions occurred. Rates (95% confidence intervals) of admissions and in‐hospital mortality among primary HF hospitalizations declined by an average annual rate of 3% (2.5%–3.5%) and 3.5% (2.9%–4.0%), respectively. Compared with 2001 to 2005, the average annual rate of decline in primary HF admissions was more in 2006 to 2009 (ie, 3.4% versus 1.1%; P=0.02). In 2010 to 2014, primary HF admission continued to decline by an average annual rate of 4.3% (95% confidence interval, 3.9%–5.1%), but this was not significantly different from 2006 to 2009 (P=0.14). In contrast, there was no further decline in in‐hospital mortality trend after the guideline‐release years. For hospitalizations with HF as the secondary diagnosis, there was an upward trend in admissions in 2001 to 2005. However, the trend began to decline in 2006 to 2009, with an average annual rate of 2.4% (95% confidence interval, 0.8%–4%). Meanwhile, there was a consistent decline in in‐hospital mortality by an average annual rate of 3.7% (95% confidence interval, 3.3%–4.2%) during the study period, but the decline was more in 2006 to 2009 compared with 2001 to 2005 (ie, 5.4% versus 3.4%; P<0.001). Beyond 2009, admission and in‐hospital mortality rates continued to decline, although this was not significantly better than the preceding interval.ConclusionsFrom 2001 to 2014, HF admission and in‐hospital mortality rates declined significantly in the United States; the greatest improvements coincided with the publication of the 2005 American College of Cardiology/American Heart Association HF guidelines.

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“…It is possible that extracardiac treatment is also responsible for comparable proportions of mortality because of HF at the end of 3 years also (60 and 62% in the IAHF and NIAHF, respectively). These mortality rates are all substantially higher, within all age groups within this cohort, than those reported in the most recent epidemiological studies for HF in the general population where, although survival has improved, the absolute mortality rates for HF remain approximately 50% within 5 years of diagnosis 13, 14. In the ARIC study, the 30‐day, 1‐year, and 5‐year case fatality rates after hospitalization for HF were 10.4, 22, and 42.3%, respectively 15…”

Section: Discussionmentioning

confidence: 61%

Characteristics of patients with haematological and breast cancer (1996–2009) who died of heart failure‐related causes after cancer therapy

et al. 2016

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AimsTo describe the characteristics and time to death of patients with breast or haematological cancer who died of heart failure (HF) after cancer therapy. Patients with an index admission for HF who died of HF‐related causes (IAHF) and those with no index admission for HF who died of HF‐related causes (NIAHF) were compared.Methods and resultsWe performed a linked data analysis of cancer registry, death registry, and hospital administration records (n = 15 987). Index HF admission must have occurred after cancer diagnosis. Of the 4894 patients who were deceased (30.6% of cohort), 734 died of HF‐related causes (50.1% female) of which 279 (38.0%) had at least one IAHF (41.9% female) post‐cancer diagnosis. Median age was 71 years [interquartile range (IQR) 62–78] for IAHF and 66 years (IQR 56–74) for NIAHF. There were fewer chemotherapy separations for IAHF patients (median = 4, IQR 2–9) compared with NIAHF patients (median = 6, IQR 2–12). Of the IAHF patients, 71% had died within 1 year of the index HF admission. There was no significant difference in HF‐related mortality in IAHF patients compared with NIAHF (HR, 1.10, 95% CI, 0.94–1.29, P = 0.225).ConclusionsThe profile of IAHF patients who died of HF‐related causes after cancer treatment matched the current profile of HF in the general population (over half were aged ≥70 years). However, NIAHF were younger (62% were aged ≤69 years), female patients with breast cancer that died of HF‐related causes before hospital admission for HF‐related causes—a group that may have been undiagnosed or undertreated until death.

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Long-Term Trends in the Incidence of and Survival with Heart Failure

Abstract: Over the past 50 years, the incidence of heart failure has declined among women but not among men, whereas survival after the onset of heart failure has improved in both sexes. Factors contributing to these trends need further clarification.

Cited by 1,923 publications

References 34 publications

Outcomes following heart failure hospitalization in a regional Australian setting between 2005 and 2014

Outcomes following heart failure hospitalization in a regional Australian setting between 2005 and 2014

National Trends in Admission and In‐Hospital Mortality of Patients With Heart Failure in the United States (2001–2014)

Characteristics of patients with haematological and breast cancer (1996–2009) who died of heart failure‐related causes after cancer therapy

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