PMID- 15880335
OWN - NLM
STAT- MEDLINE
DCOM- 20050913
LR  - 20191109
IS  - 1071-9164 (Print)
IS  - 1071-9164 (Linking)
VI  - 11
IP  - 4
DP  - 2005 May
TI  - Temporal trends in survival and hospitalizations in outpatients with chronic 
      systolic heart failure in 1995 and 1999.
PG  - 270-8
AB  - Abstract Background Community and hospital studies have suggested that survival 
      of patients with heart failure (HF) has increased; however, the causes of the 
      improvement and the hospital readmission rates remain undetermined. Methods and 
      Results We compared survival and hospital admission rates in 2 cohorts enrolled 
      in a national registry of outpatients with HF secondary to left ventricular (LV) 
      systolic dysfunction referred to cardiology centers in 1995 (n = 712) and 1999 (n 
      = 603). One year after enrollment, 163 of 1315 patients (12%) were dead. Survival 
      rates were 85% in the 1995 versus 91% in the 1999 cohort. Older age, New York 
      Heart Association (NYHA) class III-IV, anemia, hyponatremia, hypotension, and a 
      lower LV ejection fraction (LVEF) were associated to an increased risk of 
      all-cause mortality by multivariate analysis. Furthermore a significant 
      independent cohort effect was observed: the adjusted risk of death was 1.30 (95% 
      CI 1.16-1.45) for the 1995 versus 1999 cohort (survival difference adjusted P = 
      .0067). The proportion of patients admitted to hospital declined significantly in 
      1999 versus 1995, for all causes (20% versus 27%, P = .006), for cardiac causes 
      (16% versus 22%, P = .002), and for worsening congestive heart failure (8% versus 
      15%, P = .0005). Survival free from HF admission was 69% in 1995 versus 84% in 
      1999 (adjusted P = .0001); NYHA class III-IV, hypotension, diuretics and a lower 
      LVEF were associated to an increased risk of this combined end point by 
      multivariate analysis, as well as the enrollment year (relative risk 1.38, 95% CI 
      1.22-1.56, P = .0039). Conclusion In a national cardiologic registry of 
      outpatients with systolic HF, survival improved and hospital admissions decreased 
      over a 4-year period. These results underscore the importance of networking and 
      the careful implementation of practice guidelines to elevate standards of care.
FAU - Senni, Michele
AU  - Senni M
AD  - Cardiovascular Medicine, Department of Cardiovascvular and Internal Medicine, 
      Riuniti Hospital, Bergamo, Italy.
FAU - De Maria, Renata
AU  - De Maria R
FAU - Gregori, Dario
AU  - Gregori D
FAU - Gonzini, Lucio
AU  - Gonzini L
FAU - Gorini, Marco
AU  - Gorini M
FAU - Cacciatore, Giuseppe
AU  - Cacciatore G
FAU - Gavazzi, Antonello
AU  - Gavazzi A
FAU - Pulignano, Giovanni
AU  - Pulignano G
FAU - Porcu, Maurizio
AU  - Porcu M
FAU - Maggioni, Aldo P
AU  - Maggioni AP
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - J Card Fail
JT  - Journal of cardiac failure
JID - 9442138
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
RN  - 0 (Diuretics)
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Anemia/epidemiology
MH  - Angiotensin-Converting Enzyme Inhibitors/therapeutic use
MH  - Cohort Effect
MH  - Cohort Studies
MH  - Disease-Free Survival
MH  - Diuretics/therapeutic use
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/epidemiology/*mortality
MH  - Hospitalization/*statistics & numerical data
MH  - Humans
MH  - Hyponatremia/epidemiology
MH  - Hypotension/epidemiology
MH  - Italy/epidemiology
MH  - Male
MH  - Middle Aged
MH  - Patient Admission/statistics & numerical data
MH  - Prospective Studies
MH  - Sex Factors
MH  - Stroke Volume/physiology
MH  - Survival Rate
MH  - Ventricular Dysfunction, Left/epidemiology
EDAT- 2005/05/10 09:00
MHDA- 2005/09/15 09:00
CRDT- 2005/05/10 09:00
PHST- 2005/05/10 09:00 [pubmed]
PHST- 2005/09/15 09:00 [medline]
PHST- 2005/05/10 09:00 [entrez]
AID - S1071916404009327 [pii]
AID - 10.1016/j.cardfail.2004.11.003 [doi]
PST - ppublish
SO  - J Card Fail. 2005 May;11(4):270-8. doi: 10.1016/j.cardfail.2004.11.003.