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Heart Failure With Preserved, Borderline, and Reduced Ejection Fraction: 5-Year Outcomes.

Publication ,  Journal Article
Shah, KS; Xu, H; Matsouaka, RA; Bhatt, DL; Heidenreich, PA; Hernandez, AF; Devore, AD; Yancy, CW; Fonarow, GC
Published in: J Am Coll Cardiol
November 14, 2017

BACKGROUND: Patients with heart failure (HF) have a poor prognosis and are categorized by ejection fraction (EF). OBJECTIVES: This study sought to characterize differences in outcomes in patients hospitalized with heart failure with preserved ejection fraction (HFpEF) (EF ≥50%), heart failure with borderline ejection fraction (HFbEF) (EF 41% to 49%), and heart failure with reduced ejection fraction (HFrEF) (EF ≤40%). METHODS: Data from GWTG-HF (Get With The Guidelines-Heart Failure) were linked to Medicare data for longitudinal follow-up. Multivariable models were constructed to examine 5-year outcomes and to compare survival to median survival of the U.S. RESULTS: A total of 39,982 patients from 254 hospitals who were admitted for HF between 2005 and 2009 were included: 18,299 (46%) had HFpEF, 3,285 (8.2%) had HFbEF, and 18,398 (46%) had HFrEF. Overall, median survival was 2.1 years. In risk-adjusted survival analysis, all 3 groups had similar 5-year mortality (HFrEF 75.3% vs. HFpEF 75.7%; hazard ratio: 0.99 [95% confidence interval: 0.958 to 1.022]; HFbEF 75.7% vs. HFpEF 75.7%; hazard ratio: 0.99 [95% confidence interval: 0.947 to 1.046]). In risk-adjusted analyses, the composite of mortality and rehospitalization was similar for all subgroups. Cardiovascular and HF readmission rates were higher in those with HFrEF and HFbEF compared with those with HFpEF. When compared with the U.S. population, HF patients across all age and EF groups had markedly lower median survival. CONCLUSIONS: Among patients hospitalized with HF, patients across the EF spectrum have a similarly poor 5-year survival with an elevated risk for cardiovascular and HF admission. These findings underscore the need to improve treatment of patients with HF.

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Published In

J Am Coll Cardiol

DOI

EISSN

1558-3597

Publication Date

November 14, 2017

Volume

70

Issue

20

Start / End Page

2476 / 2486

Location

United States

Related Subject Headings

  • United States
  • Time Factors
  • Survival Rate
  • Stroke Volume
  • Retrospective Studies
  • Male
  • Humans
  • Hospitalization
  • Heart Failure
  • Female
 

Citation

APA
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MLA
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Shah, K. S., Xu, H., Matsouaka, R. A., Bhatt, D. L., Heidenreich, P. A., Hernandez, A. F., … Fonarow, G. C. (2017). Heart Failure With Preserved, Borderline, and Reduced Ejection Fraction: 5-Year Outcomes. J Am Coll Cardiol, 70(20), 2476–2486. https://doi.org/10.1016/j.jacc.2017.08.074
Shah, Kevin S., Haolin Xu, Roland A. Matsouaka, Deepak L. Bhatt, Paul A. Heidenreich, Adrian F. Hernandez, Adam D. Devore, Clyde W. Yancy, and Gregg C. Fonarow. “Heart Failure With Preserved, Borderline, and Reduced Ejection Fraction: 5-Year Outcomes.J Am Coll Cardiol 70, no. 20 (November 14, 2017): 2476–86. https://doi.org/10.1016/j.jacc.2017.08.074.
Shah KS, Xu H, Matsouaka RA, Bhatt DL, Heidenreich PA, Hernandez AF, et al. Heart Failure With Preserved, Borderline, and Reduced Ejection Fraction: 5-Year Outcomes. J Am Coll Cardiol. 2017 Nov 14;70(20):2476–86.
Shah, Kevin S., et al. “Heart Failure With Preserved, Borderline, and Reduced Ejection Fraction: 5-Year Outcomes.J Am Coll Cardiol, vol. 70, no. 20, Nov. 2017, pp. 2476–86. Pubmed, doi:10.1016/j.jacc.2017.08.074.
Shah KS, Xu H, Matsouaka RA, Bhatt DL, Heidenreich PA, Hernandez AF, Devore AD, Yancy CW, Fonarow GC. Heart Failure With Preserved, Borderline, and Reduced Ejection Fraction: 5-Year Outcomes. J Am Coll Cardiol. 2017 Nov 14;70(20):2476–2486.
Journal cover image

Published In

J Am Coll Cardiol

DOI

EISSN

1558-3597

Publication Date

November 14, 2017

Volume

70

Issue

20

Start / End Page

2476 / 2486

Location

United States

Related Subject Headings

  • United States
  • Time Factors
  • Survival Rate
  • Stroke Volume
  • Retrospective Studies
  • Male
  • Humans
  • Hospitalization
  • Heart Failure
  • Female