Heart failure outcomes by left ventricular ejection fraction in a contemporary region-wide patient cohort

被引:3
作者
Sundstrom, Johan [1 ,2 ]
Arnlov, Johan [3 ,4 ]
Karayiannides, Stelios [5 ,6 ]
Bodegard, Johan [7 ]
Ersmark, Karolina [8 ]
Gustafsson, Stefan [9 ]
Cars, Thomas [9 ]
Svensson, Maria K. [10 ]
Norhammar, Anna [11 ,12 ]
机构
[1] Uppsala Univ, Dept Med Sci, Entrance 40,5th Floor, S-75185 Uppsala, Sweden
[2] Univ New South Wales, George Inst Global Hlth, Sydney, NSW, Australia
[3] Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Family Med, Huddinge, Sweden
[4] Dalarna Univ, Sch Hlth & Social Studies, Falun, Sweden
[5] Karolinska Inst, Danderyd Hosp, Dept Clin Sci, Stockholm, Sweden
[6] Acad Specialist Ctr, Ctr Diabet, Reg Stockholm, Stockholm, Sweden
[7] AstraZeneca, Cardiovasc Renal & Metab, BioPharmaceut, Dept Med, Gothenburg, Sweden
[8] AstraZeneca, Cardiovasc Renal & Metab, BioPharmaceut, Dept Med, Stockholm, Sweden
[9] Sence Res AB, Uppsala, Sweden
[10] Uppsala Univ, Dept Med Sci, Renal Med, Uppsala, Sweden
[11] Karolinska Inst, Dept Med, Cardiol Unit, Stockholm, Sweden
[12] Capio St Gorans Hosp, Stockholm, Sweden
来源
ESC HEART FAILURE | 2024年 / 11卷 / 03期
关键词
Heart failure; Left ventricular ejection fraction; HFpEF; HFmrEF; HFrEF; GUIDELINES;
D O I
10.1002/ehf2.14685
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims This study aimed to characterize a contemporary population with subtypes of incident or prevalent heart failure (HF) based on reduced (HFrEF), mildly reduced, or preserved (HFpEF) left ventricular ejection fraction (LVEF) and to assess how outcomes, healthcare, treatments, and healthcare costs vary between each subtype of incident HF. Methods and results Using Swedish data from the CardioRenal and Metabolic disease Heart Failure (CaReMe HF) study, updated to cover a more recent time period, this population-based study characterized patients from Stockholm County, Sweden, with incident HF (patients with a first HF diagnosis between 1 January 2015 and 31 December 2019) or prevalent HF (patients with a first HF diagnosis before 1 January 2020). Patients with incident HF had LVEF measured by echocardiography within +/- 90 days of their first HF diagnosis, and patients with prevalent HF within 5 years prior to the index date. The 13 375 patients with prevalent HF (39.2% women, mean age 73.9 years) had multiple comorbidities (cardiovascular diseases, chronic kidney disease, diabetes, and cancer). These were already highly prevalent at the time of the first HF diagnosis in the 8042 patients with incident HF (40.5% women, mean age 72.3 years). Patients with incident HFpEF received less specialist HF care at outpatient secondary care facilities following their first HF diagnosis than those with incident HFrEF. Patients with HFrEF had higher risks of complications and exerted a higher burden, in terms of care for and costs of HF, on the healthcare system. Conclusions This study of contemporary patients with incident HF demonstrates that those with HFpEF and HFrEF differ considerably in terms of clinical presentation, prognosis, and care, highlighting a potential to improve HF outcomes.
引用
收藏
页码:1377 / 1388
页数:12
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