Comparison of outcomes after hospitalization for worsening heart failure, myocardial infarction, and stroke in patients with heart failure and reduced and preserved ejection fraction

Søren L Kristensen; Pardeep S Jhund; Lars Køber; David Preiss; John Kjekshus; Robert S McKelvie; Michael R Zile; Inder S Anand; John Wikstrand; Hans Wedel; Michel Komajda; Peter E Carson; John G F Cleland; John J V McMurray

doi:10.1002/ejhf.211

Comparison of outcomes after hospitalization for worsening heart failure, myocardial infarction, and stroke in patients with heart failure and reduced and preserved ejection fraction

Søren L Kristensen, Pardeep S Jhund, Lars Køber, David Preiss, John Kjekshus, Robert S McKelvie, Michael R Zile, Inder S Anand, John Wikstrand, Hans Wedel, Michel Komajda, Peter E Carson, John G F Cleland, John J V McMurray

Institut for Klinisk Medicin

25 Citationer (Scopus)

Abstract

AIMS: To investigate the prognostic significance of hospitalization for worsening heart failure (WHF), myocardial infarction (MI), and stroke in patients with chronic heart failure (HF).

METHODS AND RESULTS: We studied 5011 patients with HF and reduced EF (HF-REF) in the CORONA trial and 4128 patients with HF and preserved EF (HF-PEF) in the I-Preserve trial. Adjusted hazard ratios (HRs) for death were estimated for 0-30 days and ≥31 days after first post-randomization WHF, MI, or stroke used as a time-dependent variable, compared with patients with none of these events. In CORONA, 1616 patients (32%) had post-randomization first events (1223 WHF, 216 MI, 177 stroke), and the adjusted HR for mortality ≤30 days after an event was: WHF 7.21 [95% confidence interval (CI) 2.05-25.40], MI 23.08 (95% CI 6.44-82.71), and stroke 32.15 (95% CI 8.93-115.83). The HR for mortality at >30 days was: WHF 3.62 (95% CI 3.11-4.21), MI 4.41 (95% CI 3.23-6.02), and stroke 3.19 (95% CI 2.21-4.61). In I-Preserve, 896 patients (22%) experienced a post-randomization event (638 WHF, 111 MI, 147 stroke). The HR for mortality ≤30 days was WHF 31.77 (95% CI 7.60-132.81), MI 154.77 (95% CI 34.21-700.17), and stroke 223.30 (95% CI 51.42-969.78); for >30 days it was WHF 3.36 (95% CI 2.79-4.05), MI 3.29 (95% CI 2.14-5.06), and stroke 5.13 (95% CI 3.61-7.29).

CONCLUSIONS: In patients with both HF-REF and HF-PEF, hospitalization for WHF was associated with high early and late mortality. The early relative risk of death was not as great as following MI or stroke, but the longer term relative risk of death was similar following all three types of event. Numerically, more deaths occurred following WHF because it was a much more common event.

Originalsprog	Engelsk
Tidsskrift	European Journal of Heart Failure
Vol/bind	17
Udgave nummer	2
Sider (fra-til)	169-76
Antal sider	8
ISSN	1388-9842
DOI	https://doi.org/10.1002/ejhf.211
Status	Udgivet - 1 feb. 2015

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10.1002/ejhf.211

ejhf.211Forlagets udgivne version, 224 KB

https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/ejhf.211

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Kristensen, S. L., Jhund, P. S., Køber, L., Preiss, D., Kjekshus, J., McKelvie, R. S., Zile, M. R., Anand, I. S., Wikstrand, J., Wedel, H., Komajda, M., Carson, P. E., Cleland, J. G. F., & McMurray, J. J. V. (2015). Comparison of outcomes after hospitalization for worsening heart failure, myocardial infarction, and stroke in patients with heart failure and reduced and preserved ejection fraction. European Journal of Heart Failure, 17(2), 169-76. https://doi.org/10.1002/ejhf.211

Comparison of outcomes after hospitalization for worsening heart failure, myocardial infarction, and stroke in patients with heart failure and reduced and preserved ejection fraction. / Kristensen, Søren L; Jhund, Pardeep S; Køber, Lars et al.

I: European Journal of Heart Failure, Bind 17, Nr. 2, 01.02.2015, s. 169-76.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Kristensen, SL, Jhund, PS, Køber, L, Preiss, D, Kjekshus, J, McKelvie, RS, Zile, MR, Anand, IS, Wikstrand, J, Wedel, H, Komajda, M, Carson, PE, Cleland, JGF & McMurray, JJV 2015, 'Comparison of outcomes after hospitalization for worsening heart failure, myocardial infarction, and stroke in patients with heart failure and reduced and preserved ejection fraction', European Journal of Heart Failure, bind 17, nr. 2, s. 169-76. https://doi.org/10.1002/ejhf.211

@article{e64fafb04cad403ea03fddddc794bca5,

title = "Comparison of outcomes after hospitalization for worsening heart failure, myocardial infarction, and stroke in patients with heart failure and reduced and preserved ejection fraction",

abstract = "AIMS: To investigate the prognostic significance of hospitalization for worsening heart failure (WHF), myocardial infarction (MI), and stroke in patients with chronic heart failure (HF).METHODS AND RESULTS: We studied 5011 patients with HF and reduced EF (HF-REF) in the CORONA trial and 4128 patients with HF and preserved EF (HF-PEF) in the I-Preserve trial. Adjusted hazard ratios (HRs) for death were estimated for 0-30 days and ≥31 days after first post-randomization WHF, MI, or stroke used as a time-dependent variable, compared with patients with none of these events. In CORONA, 1616 patients (32%) had post-randomization first events (1223 WHF, 216 MI, 177 stroke), and the adjusted HR for mortality ≤30 days after an event was: WHF 7.21 [95% confidence interval (CI) 2.05-25.40], MI 23.08 (95% CI 6.44-82.71), and stroke 32.15 (95% CI 8.93-115.83). The HR for mortality at >30 days was: WHF 3.62 (95% CI 3.11-4.21), MI 4.41 (95% CI 3.23-6.02), and stroke 3.19 (95% CI 2.21-4.61). In I-Preserve, 896 patients (22%) experienced a post-randomization event (638 WHF, 111 MI, 147 stroke). The HR for mortality ≤30 days was WHF 31.77 (95% CI 7.60-132.81), MI 154.77 (95% CI 34.21-700.17), and stroke 223.30 (95% CI 51.42-969.78); for >30 days it was WHF 3.36 (95% CI 2.79-4.05), MI 3.29 (95% CI 2.14-5.06), and stroke 5.13 (95% CI 3.61-7.29).CONCLUSIONS: In patients with both HF-REF and HF-PEF, hospitalization for WHF was associated with high early and late mortality. The early relative risk of death was not as great as following MI or stroke, but the longer term relative risk of death was similar following all three types of event. Numerically, more deaths occurred following WHF because it was a much more common event.",

keywords = "Aged, Aged, 80 and over, Cohort Studies, Female, Heart Failure, Hospitalization, Humans, Male, Middle Aged, Myocardial Infarction, Patient Outcome Assessment, Stroke, Stroke Volume",

author = "Kristensen, {S{\o}ren L} and Jhund, {Pardeep S} and Lars K{\o}ber and David Preiss and John Kjekshus and McKelvie, {Robert S} and Zile, {Michael R} and Anand, {Inder S} and John Wikstrand and Hans Wedel and Michel Komajda and Carson, {Peter E} and Cleland, {John G F} and McMurray, {John J V}",

note = "{\textcopyright} 2014 The Authors. European Journal of Heart Failure {\textcopyright} 2014 European Society of Cardiology.",

year = "2015",

month = feb,

day = "1",

doi = "10.1002/ejhf.211",

language = "English",

volume = "17",

pages = "169--76",

journal = "European Journal of Heart Failure, Supplement",

issn = "1567-4215",

publisher = "JohnWiley & Sons Ltd",

number = "2",

}

TY - JOUR

T1 - Comparison of outcomes after hospitalization for worsening heart failure, myocardial infarction, and stroke in patients with heart failure and reduced and preserved ejection fraction

AU - Kristensen, Søren L

AU - Jhund, Pardeep S

AU - Køber, Lars

AU - Preiss, David

AU - Kjekshus, John

AU - McKelvie, Robert S

AU - Zile, Michael R

AU - Anand, Inder S

AU - Wikstrand, John

AU - Wedel, Hans

AU - Komajda, Michel

AU - Carson, Peter E

AU - Cleland, John G F

AU - McMurray, John J V

PY - 2015/2/1

Y1 - 2015/2/1

N2 - AIMS: To investigate the prognostic significance of hospitalization for worsening heart failure (WHF), myocardial infarction (MI), and stroke in patients with chronic heart failure (HF).METHODS AND RESULTS: We studied 5011 patients with HF and reduced EF (HF-REF) in the CORONA trial and 4128 patients with HF and preserved EF (HF-PEF) in the I-Preserve trial. Adjusted hazard ratios (HRs) for death were estimated for 0-30 days and ≥31 days after first post-randomization WHF, MI, or stroke used as a time-dependent variable, compared with patients with none of these events. In CORONA, 1616 patients (32%) had post-randomization first events (1223 WHF, 216 MI, 177 stroke), and the adjusted HR for mortality ≤30 days after an event was: WHF 7.21 [95% confidence interval (CI) 2.05-25.40], MI 23.08 (95% CI 6.44-82.71), and stroke 32.15 (95% CI 8.93-115.83). The HR for mortality at >30 days was: WHF 3.62 (95% CI 3.11-4.21), MI 4.41 (95% CI 3.23-6.02), and stroke 3.19 (95% CI 2.21-4.61). In I-Preserve, 896 patients (22%) experienced a post-randomization event (638 WHF, 111 MI, 147 stroke). The HR for mortality ≤30 days was WHF 31.77 (95% CI 7.60-132.81), MI 154.77 (95% CI 34.21-700.17), and stroke 223.30 (95% CI 51.42-969.78); for >30 days it was WHF 3.36 (95% CI 2.79-4.05), MI 3.29 (95% CI 2.14-5.06), and stroke 5.13 (95% CI 3.61-7.29).CONCLUSIONS: In patients with both HF-REF and HF-PEF, hospitalization for WHF was associated with high early and late mortality. The early relative risk of death was not as great as following MI or stroke, but the longer term relative risk of death was similar following all three types of event. Numerically, more deaths occurred following WHF because it was a much more common event.

AB - AIMS: To investigate the prognostic significance of hospitalization for worsening heart failure (WHF), myocardial infarction (MI), and stroke in patients with chronic heart failure (HF).METHODS AND RESULTS: We studied 5011 patients with HF and reduced EF (HF-REF) in the CORONA trial and 4128 patients with HF and preserved EF (HF-PEF) in the I-Preserve trial. Adjusted hazard ratios (HRs) for death were estimated for 0-30 days and ≥31 days after first post-randomization WHF, MI, or stroke used as a time-dependent variable, compared with patients with none of these events. In CORONA, 1616 patients (32%) had post-randomization first events (1223 WHF, 216 MI, 177 stroke), and the adjusted HR for mortality ≤30 days after an event was: WHF 7.21 [95% confidence interval (CI) 2.05-25.40], MI 23.08 (95% CI 6.44-82.71), and stroke 32.15 (95% CI 8.93-115.83). The HR for mortality at >30 days was: WHF 3.62 (95% CI 3.11-4.21), MI 4.41 (95% CI 3.23-6.02), and stroke 3.19 (95% CI 2.21-4.61). In I-Preserve, 896 patients (22%) experienced a post-randomization event (638 WHF, 111 MI, 147 stroke). The HR for mortality ≤30 days was WHF 31.77 (95% CI 7.60-132.81), MI 154.77 (95% CI 34.21-700.17), and stroke 223.30 (95% CI 51.42-969.78); for >30 days it was WHF 3.36 (95% CI 2.79-4.05), MI 3.29 (95% CI 2.14-5.06), and stroke 5.13 (95% CI 3.61-7.29).CONCLUSIONS: In patients with both HF-REF and HF-PEF, hospitalization for WHF was associated with high early and late mortality. The early relative risk of death was not as great as following MI or stroke, but the longer term relative risk of death was similar following all three types of event. Numerically, more deaths occurred following WHF because it was a much more common event.

KW - Aged

KW - Aged, 80 and over

KW - Cohort Studies

KW - Female

KW - Heart Failure

KW - Hospitalization

KW - Humans

KW - Male

KW - Middle Aged

KW - Myocardial Infarction

KW - Patient Outcome Assessment

KW - Stroke

KW - Stroke Volume

U2 - 10.1002/ejhf.211

DO - 10.1002/ejhf.211

M3 - Journal article

C2 - 25756844

SN - 1567-4215

VL - 17

SP - 169

EP - 176

JO - European Journal of Heart Failure, Supplement

JF - European Journal of Heart Failure, Supplement

IS - 2

ER -

Comparison of outcomes after hospitalization for worsening heart failure, myocardial infarction, and stroke in patients with heart failure and reduced and preserved ejection fraction

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