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Temporal Trends in Risk Profiles Among Patients Hospitalized for Heart Failure.
Hamo, Carine E; Fonarow, Gregg C; Greene, Stephen J; Vaduganathan, Muthiah; Yancy, Clyde W; Heidenreich, Paul; Lu, Di; Matsouaka, Roland A; DeVore, Adam D; Butler, Javed.
Afiliação
  • Hamo CE; Division of Cardiology, Johns Hopkins University, Baltimore, MD.
  • Fonarow GC; Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan UCLA Medical Center, Los Angeles, CA.
  • Greene SJ; Duke Clinical Research Institute, Durham, NC; Division of Cardiology, Duke University School of Medicine, Durham, NC.
  • Vaduganathan M; Brigham and Women's Hospital Heart & Vascular Center, Boston, MA.
  • Yancy CW; Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL.
  • Heidenreich P; Division of Cardiology, Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA.
  • Lu D; Duke Clinical Research Institute, Durham, NC.
  • Matsouaka RA; Duke Clinical Research Institute, Durham, NC; Department of Biostatistics and Bioinformatics, Duke University, Durham, NC.
  • DeVore AD; Duke Clinical Research Institute, Durham, NC; Division of Cardiology, Duke University School of Medicine, Durham, NC.
  • Butler J; University of Mississippi Medical Center, Jackson, MS. Electronic address: Jbutler4@umc.edu.
Am Heart J ; 2020 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-33264607
ABSTRACT

BACKGROUND:

Post-discharge mortality following hospitalization for heart failure with reduced ejection fraction (HFrEF) has remained high and unchanged over the past two decades, despite effective therapies for HFrEF. We aimed to explore whether these patterns could in part be explained by changes in longitudinal risk profile and HF severity over time.

METHODS:

Among patients hospitalized for HF in the GWTG-HF registry from 1/2005 to 12/2018 with available data, we evaluated GWTG-HF and ADHERE risk scores, observing in-hospital mortality per-year. The risk profiles and outcomes were described overall and by subgroups based on ejection fraction (EF), diabetes mellitus (DM), sex, and age.

RESULTS:

Overall, 335,735 patients were included (50% HFrEF, 46% DM, 48% female, mean age 74 years). In-hospital mortality increased by 2.0% per year from 2005-2018. There was no significant change in mean GWTG-HF risk score overall or when stratified by EF groups (p=0.46 HFrEF, p=0.26 HF mid-range EF [HFmrEF], and p=0.72 HF preserved EF [HFpEF]), age, sex, or presence of DM. The observed/expected ratio based on the GWTG-HF risk score was 0.93 (0.91-0.96), 0.83 (0.77-0.90), 0.92 (0.89-95) for HFrEF, HFmrEF, and HFpEF, respectively. Similar findings were seen when risk was assessed using ADHERE risk score.

CONCLUSIONS:

There were no significant changes in average risk profiles among hospitalized HF patients over the study duration. These data do not support the notion that worsening risk profile explains the lack of improved outcomes despite therapeutic advances, underscoring the importance of aggressive implementation of guideline-recommended therapies and investigation of novel treatments.
Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Tipo de estudo: Estudo de etiologia / Fatores de risco Idioma: Inglês Ano de publicação: 2020 Tipo de documento: Artigo País de afiliação: Moldávia

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Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Tipo de estudo: Estudo de etiologia / Fatores de risco Idioma: Inglês Ano de publicação: 2020 Tipo de documento: Artigo País de afiliação: Moldávia
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