Ana Ruigómez1, Alexander Michel2, Mar Martín-Pérez3, Luis A García Rodríguez3. 1. Spanish Centre for Pharmacoepidemiological Research (CEIFE), Madrid, Spain. Electronic address: aruigomezs@gmail.com. 2. Global Epidemiology, Bayer Pharma AG, Berlin, Germany. 3. Spanish Centre for Pharmacoepidemiological Research (CEIFE), Madrid, Spain.
Abstract
BACKGROUND: Few studies have evaluated incidence rates and risk factors for heart failure hospitalization (HFH) and mortality starting at initial heart failure (HF) diagnosis. METHODS: Patients with a first ever recorded diagnosis of HF between January 2000 and December 2005 (N=3516) were identified from The Health Improvement Network primary care database and followed until April 2011 to identify HFHs (through linked hospitalization data) and deaths. HF patients were stratified by hospitalization status at HF diagnosis (start date), and hazard ratios (HRs) for HFH and death were estimated using Cox regression. Predictors of HF re-admission were identified by nested case-control analysis among patients hospitalized at start date, using patients with a new HFH during follow-up as cases and a set of age and sex matched controls. RESULTS: During a mean follow-up of 4.5years, 32% of incident HF patients (n=1119) had a HFH and 58.5% died (n=2056). Compared with patients not hospitalized at initial HF diagnosis (N=2759), a two-fold increased risk of HFH during follow-up, consistent over time, was seen in patients hospitalized at initial HF diagnosis (N=757); adjusted HR 2.14 (95% CI: (1.88-2.44). Major predictors of HFH were renal impairment, diabetes and prior HFH. Mortality rates were higher in HF patients hospitalized at initial HF diagnosis, but the major determinant of mortality was HFH during follow-up: HR 3.88 (95% CI: 3.53-4.26) irrespective of HFH status at initial diagnosis. CONCLUSION: Patients hospitalized at initial HF diagnosis or with a HFH thereafter are at high risk of worse outcomes.
BACKGROUND: Few studies have evaluated incidence rates and risk factors for heart failure hospitalization (HFH) and mortality starting at initial heart failure (HF) diagnosis. METHODS:Patients with a first ever recorded diagnosis of HF between January 2000 and December 2005 (N=3516) were identified from The Health Improvement Network primary care database and followed until April 2011 to identify HFHs (through linked hospitalization data) and deaths. HF patients were stratified by hospitalization status at HF diagnosis (start date), and hazard ratios (HRs) for HFH and death were estimated using Cox regression. Predictors of HF re-admission were identified by nested case-control analysis among patients hospitalized at start date, using patients with a new HFH during follow-up as cases and a set of age and sex matched controls. RESULTS: During a mean follow-up of 4.5years, 32% of incident HF patients (n=1119) had a HFH and 58.5% died (n=2056). Compared with patients not hospitalized at initial HF diagnosis (N=2759), a two-fold increased risk of HFH during follow-up, consistent over time, was seen in patients hospitalized at initial HF diagnosis (N=757); adjusted HR 2.14 (95% CI: (1.88-2.44). Major predictors of HFH were renal impairment, diabetes and prior HFH. Mortality rates were higher in HF patients hospitalized at initial HF diagnosis, but the major determinant of mortality was HFH during follow-up: HR 3.88 (95% CI: 3.53-4.26) irrespective of HFH status at initial diagnosis. CONCLUSION:Patients hospitalized at initial HF diagnosis or with a HFH thereafter are at high risk of worse outcomes.
Authors: Oliver Riedel; C Ohlmeier; D Enders; A Elsässer; D Vizcaya; A Michel; S Eberhard; N Schlothauer; J Berg; E Garbe Journal: Clin Res Cardiol Date: 2018-02-05 Impact factor: 5.460
Authors: Aidan K Cornhill; Steven Dykstra; Alessandro Satriano; Dina Labib; Yoko Mikami; Jacqueline Flewitt; Easter Prosio; Sandra Rivest; Rosa Sandonato; Andrew G Howarth; Carmen Lydell; Cathy A Eastwood; Hude Quan; Nowell Fine; Joon Lee; James A White Journal: Front Cardiovasc Med Date: 2022-06-16