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Trends in patients hospitalized with heart failure and preserved left ventricular ejection fraction: prevalence, therapies, and outcomes.

Publication ,  Journal Article
Steinberg, BA; Zhao, X; Heidenreich, PA; Peterson, ED; Bhatt, DL; Cannon, CP; Hernandez, AF; Fonarow, GC ...
Published in: Circulation
July 3, 2012

BACKGROUND: Heart failure with preserved ejection fraction (EF) is a common syndrome, but trends in treatments and outcomes are lacking. METHODS AND RESULTS: We analyzed data from 275 hospitals in Get With the Guidelines-Heart Failure from January 2005 to October 2010. Patients were stratified by EF as reduced EF (EF <40% [HF-reduced EF]), borderline EF (40%≤EF<50% [HF-borderline EF]), or preserved (EF ≥50% [HF-preserved EF]). Using multivariable models, we examined trends in therapies and outcomes. Among 110 621 patients, 50% (55 083) had HF-reduced EF, 14% (15 184) had HF-borderline EF, and 36% (40 354) had HF-preserved EF. From 2005 to 2010, the proportion of hospitalizations for HF-preserved EF increased from 33% to 39% (P<0.0001). In multivariable analyses, use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers at discharge decreased in all EF groups, and β-blocker use increased. Patients with HF-preserved EF less frequently achieved blood pressure control (adjusted odds ratio, 0.44 versus HF-reduced EF; P<0.001) and were more likely discharged to skilled nursing (adjusted odds ratio, 1.16 versus HF-reduced EF; P<0.001). In-hospital mortality for HF-preserved EF decreased from 3.32% in 2005 to 2.35% in 2010 (adjusted odds ratio, 0.89 per year; P=0.01) but was stable for patients with HF-reduced EF (3.03%-2.83%; adjusted odds ratio, 0.93 per year; P=0.10). CONCLUSIONS: Hospitalization for HF-preserved EF is increasing relative to HF-reduced EF. Although in-hospital mortality for patients with HF-preserved EF declined over the study period, an important opportunity remains for identifying evidence-based therapies in patients with HF-preserved EF.

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Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

July 3, 2012

Volume

126

Issue

1

Start / End Page

65 / 75

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • United States
  • Treatment Outcome
  • Stroke Volume
  • Prevalence
  • Practice Guidelines as Topic
  • Middle Aged
  • Male
  • Humans
  • Hospitalization
 

Citation

APA
Chicago
ICMJE
MLA
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Steinberg, B. A., Zhao, X., Heidenreich, P. A., Peterson, E. D., Bhatt, D. L., Cannon, C. P., … Get With the Guidelines Scientific Advisory Committee and Investigators, . (2012). Trends in patients hospitalized with heart failure and preserved left ventricular ejection fraction: prevalence, therapies, and outcomes. Circulation, 126(1), 65–75. https://doi.org/10.1161/CIRCULATIONAHA.111.080770
Steinberg, Benjamin A., Xin Zhao, Paul A. Heidenreich, Eric D. Peterson, Deepak L. Bhatt, Christopher P. Cannon, Adrian F. Hernandez, Gregg C. Fonarow, and Gregg C. Get With the Guidelines Scientific Advisory Committee and Investigators. “Trends in patients hospitalized with heart failure and preserved left ventricular ejection fraction: prevalence, therapies, and outcomes.Circulation 126, no. 1 (July 3, 2012): 65–75. https://doi.org/10.1161/CIRCULATIONAHA.111.080770.
Steinberg BA, Zhao X, Heidenreich PA, Peterson ED, Bhatt DL, Cannon CP, et al. Trends in patients hospitalized with heart failure and preserved left ventricular ejection fraction: prevalence, therapies, and outcomes. Circulation. 2012 Jul 3;126(1):65–75.
Steinberg, Benjamin A., et al. “Trends in patients hospitalized with heart failure and preserved left ventricular ejection fraction: prevalence, therapies, and outcomes.Circulation, vol. 126, no. 1, July 2012, pp. 65–75. Pubmed, doi:10.1161/CIRCULATIONAHA.111.080770.
Steinberg BA, Zhao X, Heidenreich PA, Peterson ED, Bhatt DL, Cannon CP, Hernandez AF, Fonarow GC, Get With the Guidelines Scientific Advisory Committee and Investigators. Trends in patients hospitalized with heart failure and preserved left ventricular ejection fraction: prevalence, therapies, and outcomes. Circulation. 2012 Jul 3;126(1):65–75.

Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

July 3, 2012

Volume

126

Issue

1

Start / End Page

65 / 75

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • United States
  • Treatment Outcome
  • Stroke Volume
  • Prevalence
  • Practice Guidelines as Topic
  • Middle Aged
  • Male
  • Humans
  • Hospitalization