Associations of Heart Failure Onset Age with All-Cause Mortality: The Kailuan Study

Objective: This study was aimed at investigating the correlations between heart failure onset age and all-cause mortality. Methods: The study examined 186,249 patients treated at Kailuan Group hospitals who underwent medical evaluations between 2006 and 2018. Biennial health assessments were conducted, and, as of December 31, 2020, 4022 heart failure instances were identified. For each patient with new-onset heart failure, four control participants were randomly selected, matched for age (within +/- 1 year) and sex. Cox regression models were used to calculate the hazard ratios of all-cause mortality across age groups. Results: The median follow-up duration was 5.25 (2.65, 8.63) years. All-cause mortality occurred in 1783 participants in the new-onset heart failure group and 2633 participants in in the control group. Refined multivariable Cox regression analysis revealed that patients with heart failure under 55 years of age had the highest relative mortality risk, with an HR (95% CI) 6.86 (4.42-10.64) with respect to their matched controls. Moreover, the relative mortality risk systematically decreased with increasing age of heart failure onset: HR (95% CI) 4.70 (3.73-5.92) for ages 55-64, HR (95% CI) 3.23 (3.73-3.81) for ages 65-74, and HR (95% CI) 1.69 (1.48-1.94) for 75 years or older. Conclusion: Heart failure significantly elevates the risk of all-cause mortality, and the risk is more pronounced with earlier manifestation of the condition.