The prognosis of heart failure in the general population. The Rotterdam Study

Mosterd, Arend; Cost, Bernard; Hoes, Arno W.; Bruijne, M.C. de; Deckers, Jaap W.; Hofman, Albert; Grobbee, Diederick E.

doi:10.1053/euhj.2000.2533

Cited by 409 publications

(262 citation statements)

References 41 publications

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“…Two studies have found that high adiponectin levels are associated with increased mortality in heart failure patients [18,19], perhaps because high levels of adiponectin are indicative of systemic wasting in this population [6]. In this regard, low body mass index, which leads to elevated adiponectin levels, is associated with increased mortality following the onset of heart failure, whereas elevated body mass index, which leads to reduced adiponectin levels, increases the risk for developing heart failure [29,30]. Similarly, hypercholesterolemia is predictive of improved survival in heart failure patients presumably because it is a surrogate marker of body mass [31].…”

Section: Discussionmentioning

confidence: 99%

Adiponectin protects against the development of systolic dysfunction following myocardial infarction

Shibata

Izumiya

Sato

et al. 2007

Journal of Molecular and Cellular Cardiology

194

142

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Section: Discussionmentioning

confidence: 99%

Adiponectin protects against the development of systolic dysfunction following myocardial infarction

Shibata

Izumiya

Sato

et al. 2007

Journal of Molecular and Cellular Cardiology

194

142

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“…HF is a complex clinical syndrome and it is the final and most severe manifestation of nearly every form of heart disease (4,5). The prognosis of HF is particularly poor, with fewer than 50% of subjects remaining alive by 5 years, and only 10% by 10 years following the initial diagnosis (14)(15)(16)(17). Likewise, we recently found that HF is an important contributor to the excess overall mortality in RA (Crow- …”

Section: Discussionmentioning

confidence: 99%

How much of the increased incidence of heart failure in rheumatoid arthritis is attributable to traditional cardiovascular risk factors and ischemic heart disease?

Crowson¹,

Nicola²,

Kremers³

et al. 2005

Arthritis & Rheumatism

145

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Objective. To compare the proportion of the risk for the development of heart failure (HF) that is attributable to traditional cardiovascular (CV) risk factors, ischemic heart disease (IHD), and alcohol abuse between subjects with and subjects without rheumatoid arthritis (RA).Methods. A population-based inception cohort of RA patients was assembled along with a similar cohort of subjects without RA. All individuals were followed up through their complete medical records, until HF incidence, death, migration, or January 1, 2001. The attributable risk of HF was estimated as the difference between the observed cumulative incidence of HF in each cohort (estimated from multivariable Cox models and adjusted for the competing risk of death) and the predicted cumulative incidence of HF in the absence of risk factors, with results expressed as a percentage of the observed cumulative incidence.Results. A total of 575 RA subjects and 583 non-RA subjects (mean age 57 years, 73% women) without HF at incidence/index date had a mean followup of 15.1 and 17.0 years, respectively. During that period, 165 RA and 115 non-RA subjects had a first episode of HF, with a cumulative incidence of 36.3% and 20.4%, respectively, at age 80 years. Among non-RA subjects, 77% of the HF at age 80 years was attributable to CV risk factors, IHD, and alcohol abuse combined, whereas among RA subjects, only 54% of the HF at age 80 years was attributable to these factors (P < 0.01). Conclusion. The excess risk of HF among RA patients is not explained by an increased frequency or effect of CV risk factors and IHD.Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease of unknown etiology, affecting ϳ1% of the adult general population (1,2). Patients with RA have twice the risk of heart failure (HF) when compared with individuals of the same age and sex without RA (3). The mechanism behind this increased risk is unknown. The etiology of HF can be multifactorial, with several clinical risk factors coexisting and interacting to produce this clinical syndrome (4,5). Ischemic heart disease (IHD) and hypertension have long been recognized as major risk factors for HF in the general population (6-9). Therefore, elimination of traditional cardiovascular (CV) risk factors and IHD is a recognized approach to prevent HF (9).However, we previously reported that the increased risk of HF in subjects with RA appears to be independent of the presence or effect of IHD and CV risk factors (3). Consequently, IHD and CV risk factors may play a different role with respect to the development and prevention of HF in RA subjects, compared with non-RA subjects. The aim of the present study was to compare the proportion of the risk for the development of HF that is attributable to traditional CV risk factors, IHD, and alcohol abuse between subjects with and subjects without RA.

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“…The probability of death for patients with stable CAD or patients in the different postevent health states was estimated by multiplying the age‐adjusted probability of death not attributed to an MI or stroke in the general population by a disease‐specific mortality multiplier (Table 1). 18, 19, 20, 21 …”

Section: Methodsmentioning

confidence: 99%

Cost‐Effectiveness of Intensifying Lipid‐Lowering Therapy With Statins Based on Individual Absolute Benefit in Coronary Artery Disease Patients

Stam‐Slob

Graaf

Greving

et al. 2017

JAHA

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BackgroundA validated prediction model estimates the absolute benefit of intensive versus standard lipid‐lowering therapy (LLT) with statins on next major cardiovascular events for individual patients with coronary artery disease. We aimed to assess whether targeting intensive LLT therapy to coronary artery disease patients with the highest predicted absolute benefit is cost‐effective compared to treating all with standard or all with intensive LLT.Methods and ResultsA lifetime Markov model was constructed for coronary artery disease patients (n=10 000) with mean age 61 years. Number of major cardiovascular events, (non) vascular death, costs, and quality‐adjusted life years (QALYs) were estimated for the following strategies: (1) standard LLT for all (reference strategy); (2) intensive LLT for those with 5‐year absolute major cardiovascular events risk reduction (ARR) ≥3%, ≥2.3%, or ≥1.5% (corresponding to ≥20%, ≥15%, or ≥10% 5‐year major cardiovascular events risk); and (3) intensive LLT for all. With intensive LLT for those with ≥3% 5‐year ARR (13% of patients), 380 QALYs were gained for €2423/QALY. Using a threshold of ≥2.3% ARR (26% of patients), 630 QALYs were gained for €5653/QALY. Using a threshold of ≥1.5% ARR (56% of patients), 1020 QALYs were gained for €10 960/QALY. By treating all intensively, 1410 QALYs were gained (0.14 QALY per patient) for €17 223/QALY. With benefit‐based treatment, 0.16 to 0.17 QALY was gained per treated patient.ConclusionsIntensive LLT with statins for all coronary artery disease patients results in the highest overall QALY gain against acceptable costs. However, the number of QALYs gained with intensive LLT by statins in individual patients can be increased with selective benefit‐based treatment.Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifiers: NCT00327691 and NCT00159835

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The prognosis of heart failure in the general population. The Rotterdam Study

Abstract: Heart failure generally afflicts older subjects in the community, carries a poor prognosis, especially in the presence of concomitant diseases, and confers a fivefold increase in the risk of sudden death.

Cited by 409 publications

References 41 publications

Adiponectin protects against the development of systolic dysfunction following myocardial infarction

Adiponectin protects against the development of systolic dysfunction following myocardial infarction

How much of the increased incidence of heart failure in rheumatoid arthritis is attributable to traditional cardiovascular risk factors and ischemic heart disease?

Cost‐Effectiveness of Intensifying Lipid‐Lowering Therapy With Statins Based on Individual Absolute Benefit in Coronary Artery Disease Patients

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