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Int J Cardiol. 2016 Dec 1;224:456-460. doi: 10.1016/j.ijcard.2016.09.062. Epub 2016 Sep 17.

Temporal trends in long-term mortality of patients with acute heart failure: Data from 1985-2008.

Author information

1
Department of Cardiology, Thoraxcentre, Erasmus Medical Centre, Rotterdam, The Netherlands.
2
Department of Medical Informatics, Erasmus University Medical Centre, Rotterdam, The Netherlands.
3
Department of Cardiology, Thoraxcentre, Erasmus Medical Centre, Rotterdam, The Netherlands. Electronic address: j.deckers@erasmusmc.nl.

Abstract

BACKGROUND:

Heart failure (HF) has a poor prognosis. Patients with acute heart failure in particular have a high risk of dying. However, there is a lack of data regarding their long-term mortality and changes there-in with time. The aim of our study was to describe trends in short- and long-term mortality of patients hospitalized with acute HF in the period from 1985 through 2008. In addition, we determined the prognostic worth of the aetiology of HF.

METHODS AND RESULTS:

We included a consecutive series of 1810 patients with acute HF in this prospective registry in the period of 1985 through 2008. The cumulative one-year mortality rate of the patients was 35%. The short-term prognosis remained unchanged over the decades. However, the cumulative mortality rate ten years after admission was lowest in the last decade (73% in 2000-2008 vs. 78% in 1985-1999, p=0.001). After multivariable adjustment, the ten-year mortality rate was lower in the last decade as compared to the first decade (hazard ratio (HR) 0.83; 95% confidence interval (CI) 0.71-0.96). Ischemic cardiomyopathy was associated with a higher mortality (HR 1.32; 95% CI 1.12-1.54) when compared to other causes of HF.

CONCLUSIONS:

Patients admitted with acute HF were found to have both high short-term and long-term mortality. Long-term prognostic improvement in the last decade was observed among patients with a reduced ejection fraction. While patients with HF due to valvular heart disease had the best prognosis, an ischemic aetiology of HF was associated with the worst outcome.

KEYWORDS:

Acute heart failure; Epidemiology; Mortality; Trends

PMID:
27723568
DOI:
10.1016/j.ijcard.2016.09.062
[Indexed for MEDLINE]

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