Outcomes in patients with heart failure with preserved, borderline, and reduced ejection fraction in the Medicare population - PubMed (original) (raw)
. 2014 Nov;168(5):721-30.
doi: 10.1016/j.ahj.2014.07.008. Epub 2014 Jul 22.
Affiliations
- PMID: 25440801
- DOI: 10.1016/j.ahj.2014.07.008
Outcomes in patients with heart failure with preserved, borderline, and reduced ejection fraction in the Medicare population
Richard K Cheng et al. Am Heart J. 2014 Nov.
Abstract
Background: Studies on outcomes among patients with heart failure (HF) with preserved left ventricular ejection fraction (HFpEF), borderline left ventricular ejection fraction (HFbEF), and reduced left ventricular ejection fraction (HFrEF) remain limited. We sought to characterize mortality and readmission in patients with HF in the contemporary era.
Methods: Get With The Guidelines-HF was linked to Medicare data for longitudinal follow-up. Patients were grouped into HFpEF (left ventricular ejection fraction [EF] ≥ 50%), HFbEF (40% ≤ EF < 50%), and HFrEF (EF < 40%). Multivariable models were constructed to examine the relationship between EF and outcomes at 30 days and 1 year and to study trends over time.
Results: A total of 40,239 patients from 220 hospitals between 2005 and 2011 were included in the study: 18,897 (47%) had HFpEF, 5,626 (14%) had HFbEF, and 15,716 (39%) had HFrEF. In crude survival analysis, patients with HFrEF had slightly increased mortality compared with HFbEF and HFpEF. After risk adjustment, mortality at 1 year was not significantly different for HFrEF, HFbEF, and HFpEF (HFrEF vs HFpEF, hazard ratio [HR] 1.040 [95% CI 0.998-1.084], and HFbEF vs HFpEF, HR 0.967 [95% CI 0.917-1.020]). Patients with HFpEF had increased risk of all-cause readmission compared with HFrEF. Conversely, risk of cardiovascular and HF readmissions were higher in HFrEF and HFbEF compared with HFpEF.
Conclusions: Among patients hospitalized with HF, patients with HFpEF and HFbEF had slightly lower mortality and higher all-cause readmission risk than patients with HFrEF, although the mortality differences did not persist after risk adjustment. Irrespective of EF, these patients experience substantial mortality and readmission highlighting the need for new therapeutic strategies.
Copyright © 2014 Elsevier Inc. All rights reserved.
Similar articles
- Heart Failure With Preserved, Borderline, and Reduced Ejection Fraction: 5-Year Outcomes.
Shah KS, Xu H, Matsouaka RA, Bhatt DL, Heidenreich PA, Hernandez AF, Devore AD, Yancy CW, Fonarow GC. Shah KS, et al. J Am Coll Cardiol. 2017 Nov 14;70(20):2476-2486. doi: 10.1016/j.jacc.2017.08.074. Epub 2017 Nov 12. J Am Coll Cardiol. 2017. PMID: 29141781 - Prognostic significance of hyponatremia among ambulatory patients with heart failure and preserved and reduced ejection fractions.
Bavishi C, Ather S, Bambhroliya A, Jneid H, Virani SS, Bozkurt B, Deswal A. Bavishi C, et al. Am J Cardiol. 2014 Jun 1;113(11):1834-8. doi: 10.1016/j.amjcard.2014.03.017. Epub 2014 Mar 18. Am J Cardiol. 2014. PMID: 24837261 - In-hospital and 1-year outcomes of acute heart failure patients according to presentation (de novo vs. worsening) and ejection fraction. Results from IN-HF Outcome Registry.
Senni M, Gavazzi A, Oliva F, Mortara A, Urso R, Pozzoli M, Metra M, Lucci D, Gonzini L, Cirrincione V, Montagna L, Di Lenarda A, Maggioni AP, Tavazzi L; IN HF Outcome Investigators. Senni M, et al. Int J Cardiol. 2014 May 1;173(2):163-9. doi: 10.1016/j.ijcard.2014.02.018. Epub 2014 Feb 22. Int J Cardiol. 2014. PMID: 24630337 - How do patients with heart failure with preserved ejection fraction die?
Chan MM, Lam CS. Chan MM, et al. Eur J Heart Fail. 2013 Jun;15(6):604-13. doi: 10.1093/eurjhf/hft062. Epub 2013 Apr 21. Eur J Heart Fail. 2013. PMID: 23610137 Review. - Sudden death in heart failure with preserved ejection fraction and beyond: an elusive target.
Manolis AS, Manolis AA, Manolis TA, Melita H. Manolis AS, et al. Heart Fail Rev. 2019 Nov;24(6):847-866. doi: 10.1007/s10741-019-09804-2. Heart Fail Rev. 2019. PMID: 31147814 Review.
Cited by
- Outcomes among acute heart failure emergency department patients by preserved vs. reduced ejection fraction.
Sax DR, Rana JS, Mark DG, Huang J, Collins SP, Liu D, Storrow AB, Reed ME; KP CREST Network. Sax DR, et al. ESC Heart Fail. 2021 Aug;8(4):2889-2898. doi: 10.1002/ehf2.13364. Epub 2021 May 12. ESC Heart Fail. 2021. PMID: 33978311 Free PMC article. - Trends in cause-specific readmissions in heart failure with preserved vs. reduced and mid-range ejection fraction.
Cui X, Thunström E, Dahlström U, Zhou J, Ge J, Fu M. Cui X, et al. ESC Heart Fail. 2020 Oct;7(5):2894-2903. doi: 10.1002/ehf2.12899. Epub 2020 Jul 30. ESC Heart Fail. 2020. PMID: 32729678 Free PMC article. - Characteristics, Prognosis, and Prediction Model of Heart Failure Patients in Intensive Care Units Based on Preserved, Mildly Reduced, and Reduced Ejection Fraction.
Tao F, Wang W, Yang H, Han X, Wang X, Dai Y, Zhu A, Han Y, Guo P. Tao F, et al. Rev Cardiovasc Med. 2023 Jun 6;24(6):165. doi: 10.31083/j.rcm2406165. eCollection 2023 Jun. Rev Cardiovasc Med. 2023. PMID: 39077540 Free PMC article. - Pharmacodynamic and Pharmacokinetic Interaction Profile of Vericiguat: Results from Three Randomized Phase I Studies in Healthy Volunteers.
Boettcher M, Loewen S, Gerrits M, Becker C. Boettcher M, et al. Clin Pharmacokinet. 2021 Mar;60(3):337-351. doi: 10.1007/s40262-020-00935-6. Clin Pharmacokinet. 2021. PMID: 33030703 Free PMC article. Clinical Trial. - Heart Failure with Preserved Ejection Fraction: a Pharmacotherapeutic Update.
Vaz-Salvador P, Adão R, Vasconcelos I, Leite-Moreira AF, Brás-Silva C. Vaz-Salvador P, et al. Cardiovasc Drugs Ther. 2023 Aug;37(4):815-832. doi: 10.1007/s10557-021-07306-8. Epub 2022 Jan 31. Cardiovasc Drugs Ther. 2023. PMID: 35098432 Free PMC article. Review.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
Research Materials
Miscellaneous