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HF progression among outpatients with HF in a community setting.

Abstract：

BACKGROUND:Incidence and prognostic impact of heart failure (HF) progression has been not well addressed. METHODS:From 2009 until 2015, consecutive ambulatory HF patients were recruited. HF progression was defined by the presence of at least two of the following criteria: step up of ≥1 New York Heart Association (NYHA) class; decrease LVEF ≥ 10 points; association of diuretics or increase ≥ 50% of furosemide dosage, or HF hospitalization. RESULTS:2528 met study criteria (mean age 76; 42% women). Of these, 48% had ischemic heart disease, 18% patients with LVEF ≤ 35%. During a median follow-up of 2.4 years, overall mortality was 31% (95% CI: 29%-33%), whereas rate of HF progression or death was 57% (95% CI: 55%-59%). The 4-year incidence of HF progression was 39% (95% CI: 37%-41%) whereas the competing mortality rate was 18% (95% CI: 16%-19%). Rates of HF progression and death were higher in HF patients with LVEF ≤ 35% vs >35% (HF progression: 42% vs 38%, p = 0.012; death as a competing risk: 22% vs 17%, p = 0.002). HF progression identified HF patients with a worse survival (HR = 3.16, 95% CI: 2.75-3.72). In cause-specific Cox models, age, previous HF hospitalization, chronic obstructive pulmonary disease, chronic kidney disease, anemia, sex, LVEF ≤ 35% emerged as prognostic factors of HF progression. CONCLUSIONS:Among outpatients with HF, at 4 years 39% presented a HF progression, while 18% died before any sign of HF progression. This trend was higher in patients with LVEF ≤ 35%. These findings may have implications for healthcare planning and resource allocation.

journal_name

Int J Cardiol

journal_title

International journal of cardiology

authors

Iorio A,Rea F,Barbati G,Scagnetto A,Peruzzi E,Garavaglia A,Corrao G,Sinagra G,Di Lenarda A

doi

10.1016/j.ijcard.2018.08.049

subject

Has Abstract

pub_date

2019-02-15 00:00:00

pages

140-146

eissn

0167-5273

issn

1874-1754

pii

S0167-5273(18)34223-2

journal_volume

277

pub_type

杂志文章

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