Prognostic impact over time of ischaemic heart disease vs. non-ischaemic heart disease in heart failure.
Aetiology
Chronic ischaemic heart disease
Heart failure
Mortality/survival
Prognosis
Risk factors
Journal
ESC heart failure
ISSN: 2055-5822
Titre abrégé: ESC Heart Fail
Pays: England
ID NLM: 101669191
Informations de publication
Date de publication:
02 2020
02 2020
Historique:
received:
03
06
2019
revised:
09
10
2019
accepted:
04
11
2019
pubmed:
8
1
2020
medline:
14
4
2021
entrez:
8
1
2020
Statut:
ppublish
Résumé
The aim of this study is to investigate the prognostic impact of ischaemic heart disease (IHD) in heart failure (HF) and its association to age, sex, left ventricular ejection fraction (EF), and HF duration, and furthermore, to evaluate if the impact of IHD has changed over time, in light of improved therapy. We studied 30 946 patients with non-valvular HF, by accessing the Swedish Heart Failure Registry, from years 2000 to 2012. The mortality in 17 778 patients with clinical IHD was compared with 13 168 patients without IHD (non-IHD). There was a significantly worse outcome in IHD, with the crude mortality of 41.1% and the event rate per 100 person-years [95% confidence interval (CI)] of 14.8 (14.4-15.1), compared with 28.2% and 9.7 (9.4-10.0) in non-IHD. After multivariable adjustment, the hazard ratio (HR) (95% CI) for mortality, IHD vs. non-IHD, was 1.16 (1.11-1.22; P < 0.0001). Subgroup analyses showed significantly increased mortality in IHD, in all age subgroups, in all subgroups with EF < 50%, in both men and women, and regardless of heart failure duration more or less than 6 months. Analyses for the combination of age and EF showed the highest HR for time to death in the youngest with the lowest EF, HR (95% CI) 2.05 (1.59-2.64) for patients <60 years of age with EF < 30%. Although a numerical reduction of the HR for mortality was seen over time, the risk for mortality in IHD, compared with the non-IHD group, was greater throughout the study period. In non-valvular heart failure, IHD was associated with significantly increased mortality, compared with non-IHD, in groups of EF below 50%, in all age groups, and regardless of sex or HF duration. The risk increase associated with EF reduction diminished with increasing age. The mortality in IHD, compared with non-IHD, remained significantly higher throughout the 13 year study period.
Identifiants
pubmed: 31908162
doi: 10.1002/ehf2.12568
pmc: PMC7083496
doi:
Types de publication
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
264-273Subventions
Organisme : Swedish Society of Cardiology
Pays : International
Organisme : Swedish Association of Local Authorities and Regions
Pays : International
Organisme : Swedish National Board of Health and Welfare
Pays : International
Organisme : Regional ALF agreement between the Region Västra Götaland and University of Gothenburg
ID : ALFGBG-721961
Pays : International
Organisme : Swedish Heart-Lung Foundation
ID : 20170453
Pays : International
Informations de copyright
© 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.
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