Chih M Wong1, Nathaniel M Hawkins2, Mark C Petrie3, Pardeep S Jhund4, Roy S Gardner3, Cono A Ariti5, Katrina K Poppe6, Nikki Earle6, Gillian A Whalley7, Iain B Squire8, Robert N Doughty9, John J V McMurray4. 1. BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK Scottish National Advanced Heart Failure Service, Golden Jubilee National Hospital, Clydebank, Glasgow, UK chihmun@gmail.com. 2. Division of Cardiology, University of British Columbia, Vancouver, BC, Canada. 3. Scottish National Advanced Heart Failure Service, Golden Jubilee National Hospital, Clydebank, Glasgow, UK. 4. BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK. 5. Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK. 6. Department of Medicine, The University of Auckland, Auckland, New Zealand. 7. Unitec, Auckland, New Zealand. 8. Department of Cardiovascular Sciences, University of Leicester, Leicester, UK Leicester Cardiovascular Biomedical Research Unit, University of Leicester, Leicester, UK. 9. Department of Medicine, The University of Auckland, Auckland, New Zealand National Institute for Health Innovation, The University of Auckland, Auckland, New Zealand.
Abstract
AIM: Our understanding of heart failure in younger patients is limited. The Meta-analysis Global Group in Chronic Heart Failure (MAGGIC) database, which consisted of 24 prospective observational studies and 7 randomized trials, was used to investigate the clinical characteristics, treatment, and outcomes of younger patients. METHODS AND RESULTS: Patients were stratified into six age categories: <40 (n = 876), 40-49 (n = 2638), 50-59 (n = 6894), 60-69 (n = 12 071), 70-79 (n = 13 368), and ≥80 years (n = 6079). Of 41 926 patients, 2.1, 8.4, and 24.8% were younger than 40, 50, and 60 years of age, respectively. Comparing young (<40 years) against elderly (≥80 years), younger patients were more likely to be male (71 vs. 48%) and have idiopathic cardiomyopathy (63 vs. 7%). Younger patients reported better New York Heart Association functional class despite more severe left ventricular dysfunction (median ejection fraction: 31 vs. 42%, all P < 0.0001). Comorbidities such as hypertension, myocardial infarction, and atrial fibrillation were much less common in the young. Younger patients received more disease-modifying pharmacological therapy than their older counterparts. Across the younger age groups (<40, 40-49, and 50-59 years), mortality rates were low: 1 year 6.7, 6.6, and 7.5%, respectively; 2 year 11.7, 11.5, 13.0%; and 3 years 16.5, 16.2, 18.2%. Furthermore, 1-, 2-, and 3-year mortality rates increased sharply beyond 60 years and were greatest in the elderly (≥80 years): 28.2, 44.5, and 57.2%, respectively. CONCLUSION: Younger patients with heart failure have different clinical characteristics including different aetiologies, more severe left ventricular dysfunction, and less severe symptoms. Three-year mortality rates are lower for all age groups under 60 years compared with older patients. Published on behalf of the European Society of Cardiology. All rights reserved.
AIM: Our understanding of heart failure in younger patients is limited. The Meta-analysis Global Group in Chronic Heart Failure (MAGGIC) database, which consisted of 24 prospective observational studies and 7 randomized trials, was used to investigate the clinical characteristics, treatment, and outcomes of younger patients. METHODS AND RESULTS:Patients were stratified into six age categories: <40 (n = 876), 40-49 (n = 2638), 50-59 (n = 6894), 60-69 (n = 12 071), 70-79 (n = 13 368), and ≥80 years (n = 6079). Of 41 926 patients, 2.1, 8.4, and 24.8% were younger than 40, 50, and 60 years of age, respectively. Comparing young (<40 years) against elderly (≥80 years), younger patients were more likely to be male (71 vs. 48%) and have idiopathic cardiomyopathy (63 vs. 7%). Younger patients reported better New York Heart Association functional class despite more severe left ventricular dysfunction (median ejection fraction: 31 vs. 42%, all P < 0.0001). Comorbidities such as hypertension, myocardial infarction, and atrial fibrillation were much less common in the young. Younger patients received more disease-modifying pharmacological therapy than their older counterparts. Across the younger age groups (<40, 40-49, and 50-59 years), mortality rates were low: 1 year 6.7, 6.6, and 7.5%, respectively; 2 year 11.7, 11.5, 13.0%; and 3 years 16.5, 16.2, 18.2%. Furthermore, 1-, 2-, and 3-year mortality rates increased sharply beyond 60 years and were greatest in the elderly (≥80 years): 28.2, 44.5, and 57.2%, respectively. CONCLUSION: Younger patients with heart failure have different clinical characteristics including different aetiologies, more severe left ventricular dysfunction, and less severe symptoms. Three-year mortality rates are lower for all age groups under 60 years compared with older patients. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Mark C Petrie; Pardeep S Jhund; Lilin She; Christopher Adlbrecht; Torsten Doenst; Julio A Panza; James A Hill; Kerry L Lee; Jean L Rouleau; David L Prior; Imtiaz S Ali; Jyotsna Maddury; Krzysztof S Golba; Harvey D White; Peter Carson; Lukasz Chrzanowski; Alexander Romanov; Alan B Miller; Eric J Velazquez Journal: Circulation Date: 2016-08-29 Impact factor: 29.690
Authors: Sarah C Snow; Gregg C Fonarow; Joseph A Ladapo; Donna L Washington; Katherine J Hoggatt; Boback Ziaeian Journal: Am J Med Date: 2018-12-16 Impact factor: 4.965