PMID- 30131230
OWN - NLM
STAT- MEDLINE
DCOM- 20190903
LR  - 20190903
IS  - 1874-1754 (Electronic)
IS  - 0167-5273 (Linking)
VI  - 277
DP  - 2019 Feb 15
TI  - HF progression among outpatients with HF in a community setting.
PG  - 140-146
LID - S0167-5273(18)34223-2 [pii]
LID - 10.1016/j.ijcard.2018.08.049 [doi]
AB  - BACKGROUND: Incidence and prognostic impact of heart failure (HF) progression has 
      been not well addressed. METHODS: From 2009 until 2015, consecutive ambulatory HF 
      patients were recruited. HF progression was defined by the presence of at least 
      two of the following criteria: step up of >/=1 New York Heart Association (NYHA) 
      class; decrease LVEF >/= 10 points; association of diuretics or increase >/= 50% of 
      furosemide dosage, or HF hospitalization. RESULTS: 2528 met study criteria (mean 
      age 76; 42% women). Of these, 48% had ischemic heart disease, 18% patients with 
      LVEF </= 35%. During a median follow-up of 2.4 years, overall mortality was 31% 
      (95% CI: 29%-33%), whereas rate of HF progression or death was 57% (95% CI: 
      55%-59%). The 4-year incidence of HF progression was 39% (95% CI: 37%-41%) 
      whereas the competing mortality rate was 18% (95% CI: 16%-19%). Rates of HF 
      progression and death were higher in HF patients with LVEF </= 35% vs >35% (HF 
      progression: 42% vs 38%, p = 0.012; death as a competing risk: 22% vs 17%, 
      p = 0.002). HF progression identified HF patients with a worse survival 
      (HR = 3.16, 95% CI: 2.75-3.72). In cause-specific Cox models, age, previous HF 
      hospitalization, chronic obstructive pulmonary disease, chronic kidney disease, 
      anemia, sex, LVEF </= 35% emerged as prognostic factors of HF progression. 
      CONCLUSIONS: Among outpatients with HF, at 4 years 39% presented a HF 
      progression, while 18% died before any sign of HF progression. This trend was 
      higher in patients with LVEF </= 35%. These findings may have implications for 
      healthcare planning and resource allocation.
CI  - Copyright (c) 2018 Elsevier B.V. All rights reserved.
FAU - Iorio, Annamaria
AU  - Iorio A
AD  - Cardiology Unit, Papa Giovanni XXIII Hospital Bergamo, Italy; Cardiovascular 
      Department, University Hospital and Health Services, Trieste, Italy.
FAU - Rea, Federico
AU  - Rea F
AD  - National Centre for Healthcare Research & Pharmacoepidemiology, at the University 
      of Milano-Bicocca, Milan, Italy; Department of Statistics and Quantitative 
      Methods, University of Milano-Bicocca, Milano, Italy. Electronic address: 
      f.rea@campus.unimib.it.
FAU - Barbati, Giulia
AU  - Barbati G
AD  - Biostatistics Unit, Department of Medical Sciences, University of Trieste, 
      Trieste, Italy; National Centre for Healthcare Research & Pharmacoepidemiology, 
      at the University of Milano-Bicocca, Milan, Italy.
FAU - Scagnetto, Arjuna
AU  - Scagnetto A
AD  - Biostatistics Unit, Department of Medical Sciences, University of Trieste, 
      Trieste, Italy.
FAU - Peruzzi, Elena
AU  - Peruzzi E
AD  - Novartis Farma, Italy.
FAU - Garavaglia, Agnese
AU  - Garavaglia A
AD  - Novartis Farma, Italy.
FAU - Corrao, Giovanni
AU  - Corrao G
AD  - National Centre for Healthcare Research & Pharmacoepidemiology, at the University 
      of Milano-Bicocca, Milan, Italy; Department of Statistics and Quantitative 
      Methods, University of Milano-Bicocca, Milano, Italy.
FAU - Sinagra, Gianfranco
AU  - Sinagra G
AD  - Cardiovascular Department, University Hospital and Health Services, Trieste, 
      Italy.
FAU - Di Lenarda, Andrea
AU  - Di Lenarda A
AD  - Cardiovascular Center, University Hospital and Health Services, Trieste, Italy.
LA  - eng
PT  - Journal Article
DEP - 20180816
PL  - Netherlands
TA  - Int J Cardiol
JT  - International journal of cardiology
JID - 8200291
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Cohort Studies
MH  - *Disease Progression
MH  - Female
MH  - Heart Failure/*diagnostic imaging/*mortality/therapy
MH  - Humans
MH  - Male
MH  - Mortality/trends
MH  - Outpatient Clinics, Hospital/*trends
MH  - *Residence Characteristics
OTO - NOTNLM
OT  - Comorbidities
OT  - Heart failure
OT  - Heart failure progression
OT  - Left ventricular ejection fraction
EDAT- 2018/08/23 06:00
MHDA- 2019/09/04 06:00
CRDT- 2018/08/23 06:00
PHST- 2018/07/04 00:00 [received]
PHST- 2018/07/28 00:00 [revised]
PHST- 2018/08/14 00:00 [accepted]
PHST- 2018/08/23 06:00 [pubmed]
PHST- 2019/09/04 06:00 [medline]
PHST- 2018/08/23 06:00 [entrez]
AID - S0167-5273(18)34223-2 [pii]
AID - 10.1016/j.ijcard.2018.08.049 [doi]
PST - ppublish
SO  - Int J Cardiol. 2019 Feb 15;277:140-146. doi: 10.1016/j.ijcard.2018.08.049. Epub 
      2018 Aug 16.