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The survival of patients with heart failure with preserved or reduced left ventricular ejection fraction: an individual patient data meta-analysis.

Publication ,  Journal Article
Meta-analysis Global Group in Chronic Heart Failure (MAGGIC),
Published in: Eur Heart J
July 2012

AIMS: A substantial proportion of patients with heart failure have preserved left ventricular ejection fraction (HF-PEF). Previous studies have reported mixed results whether survival is similar to those patients with heart failure and reduced EF (HF-REF). METHODS AND RESULTS: We compared survival in patients with HF-PEF with that in patients with HF-REF in a meta-analysis using individual patient data. Preserved EF was defined as an EF ≥ 50%. The 31 studies included 41 972 patients: 10 347 with HF-PEF and 31 625 with HF-REF. Compared with patients with HF-REF, those with HF-PEF were older (mean age 71 vs. 66 years), were more often women (50 vs. 28%), and have a history of hypertension (51 vs. 41%). Ischaemic aetiology was less common (43 vs. 59%) in patients with HF-PEF. There were 121 [95% confidence interval (CI): 117, 126] deaths per 1000 patient-years in those with HF-PEF and 141 (95% CI: 138, 144) deaths per 1000 patient-years in those with HF-REF. Patients with HF-PEF had lower mortality than those with HF-REF (adjusted for age, gender, aetiology, and history of hypertension, diabetes, and atrial fibrillation); hazard ratio 0.68 (95% CI: 0.64, 0.71). The risk of death did not increase notably until EF fell below 40%. CONCLUSION: Patients with HF-PEF have a lower risk of death than patients with HF-REF, and this difference is seen regardless of age, gender, and aetiology of HF. However, absolute mortality is still high in patients with HF-PEF highlighting the need for a treatment to improve prognosis.

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Published In

Eur Heart J

DOI

EISSN

1522-9645

Publication Date

July 2012

Volume

33

Issue

14

Start / End Page

1750 / 1757

Location

England

Related Subject Headings

  • Stroke Volume
  • Risk Factors
  • Randomized Controlled Trials as Topic
  • Male
  • Humans
  • Heart Failure
  • Female
  • Cause of Death
  • Cardiovascular System & Hematology
  • Aged
 

Citation

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Meta-analysis Global Group in Chronic Heart Failure (MAGGIC), . (2012). The survival of patients with heart failure with preserved or reduced left ventricular ejection fraction: an individual patient data meta-analysis. Eur Heart J, 33(14), 1750–1757. https://doi.org/10.1093/eurheartj/ehr254
Meta-analysis Global Group in Chronic Heart Failure (MAGGIC), Oren N. “The survival of patients with heart failure with preserved or reduced left ventricular ejection fraction: an individual patient data meta-analysis.Eur Heart J 33, no. 14 (July 2012): 1750–57. https://doi.org/10.1093/eurheartj/ehr254.
Meta-analysis Global Group in Chronic Heart Failure (MAGGIC). The survival of patients with heart failure with preserved or reduced left ventricular ejection fraction: an individual patient data meta-analysis. Eur Heart J. 2012 Jul;33(14):1750–7.
Meta-analysis Global Group in Chronic Heart Failure (MAGGIC), Oren N. “The survival of patients with heart failure with preserved or reduced left ventricular ejection fraction: an individual patient data meta-analysis.Eur Heart J, vol. 33, no. 14, July 2012, pp. 1750–57. Pubmed, doi:10.1093/eurheartj/ehr254.
Meta-analysis Global Group in Chronic Heart Failure (MAGGIC). The survival of patients with heart failure with preserved or reduced left ventricular ejection fraction: an individual patient data meta-analysis. Eur Heart J. 2012 Jul;33(14):1750–1757.
Journal cover image

Published In

Eur Heart J

DOI

EISSN

1522-9645

Publication Date

July 2012

Volume

33

Issue

14

Start / End Page

1750 / 1757

Location

England

Related Subject Headings

  • Stroke Volume
  • Risk Factors
  • Randomized Controlled Trials as Topic
  • Male
  • Humans
  • Heart Failure
  • Female
  • Cause of Death
  • Cardiovascular System & Hematology
  • Aged