Outcome of heart failure with preserved ejection fraction in a population-based study
- PMID: 16855266
- DOI: 10.1056/NEJMoa051530
Outcome of heart failure with preserved ejection fraction in a population-based study
Abstract
Background: The importance of heart failure with preserved ejection fraction is increasingly recognized. We conducted a study to evaluate the epidemiologic features and outcomes of patients with heart failure with preserved ejection fraction and to compare the findings with those from patients who had heart failure with reduced ejection fraction.
Methods: From April 1, 1999, through March 31, 2001, we studied 2802 patients admitted to 103 hospitals in the province of Ontario, Canada, with a discharge diagnosis of heart failure whose ejection fraction had also been assessed. The patients were categorized in three groups: those with an ejection fraction of less than 40 percent (heart failure with reduced ejection fraction), those with an ejection fraction of 40 to 50 percent (heart failure with borderline ejection fraction), and those with an ejection fraction of more than 50 percent (heart failure with preserved ejection fraction). Two groups were studied in detail: those with an ejection fraction of less than 40 percent and those with an ejection fraction of more than 50 percent. The main outcome measures were death within one year and readmission to the hospital for heart failure.
Results: Thirty-one percent of the patients had an ejection fraction of more than 50 percent. Patients with heart failure with preserved ejection fraction were more likely to be older and female and to have a history of hypertension and atrial fibrillation. The presenting history and clinical examination findings were similar for the two groups. The unadjusted mortality rates for patients with an ejection fraction of more than 50 percent were not significantly different from those for patients with an ejection fraction of less than 40 percent at 30 days (5 percent vs. 7 percent, P=0.08) and at 1 year (22 percent vs. 26 percent, P=0.07); the adjusted one-year mortality rates were also not significantly different in the two groups (hazard ratio, 1.13; 95 percent confidence interval, 0.94 to 1.36; P=0.18). The rates of readmission for heart failure and of in-hospital complications did not differ between the two groups.
Conclusions: Among patients presenting with new-onset heart failure, a substantial proportion had an ejection fraction of more than 50 percent. The survival of patients with heart failure with preserved ejection fraction was similar to that of patients with reduced ejection fraction.
Copyright 2006 Massachusetts Medical Society.
Comment in
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Diastolic heart failure--a common and lethal condition by any name.N Engl J Med. 2006 Jul 20;355(3):308-10. doi: 10.1056/NEJMe068128. N Engl J Med. 2006. PMID: 16855273 No abstract available.
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Heart failure with preserved ejection fraction.N Engl J Med. 2006 Oct 26;355(17):1828; author reply 1830-1. doi: 10.1056/NEJMc062229. N Engl J Med. 2006. PMID: 17065647 No abstract available.
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Heart failure with preserved ejection fraction.N Engl J Med. 2006 Oct 26;355(17):1829-30; author reply 1830-1. N Engl J Med. 2006. PMID: 17072998 No abstract available.
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Heart failure with preserved ejection fraction.N Engl J Med. 2006 Oct 26;355(17):1829; author reply 1830-1. N Engl J Med. 2006. PMID: 17072999 No abstract available.
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Heart failure with preserved ejection fraction.N Engl J Med. 2006 Oct 26;355(17):1828-9; author reply 1830-1. N Engl J Med. 2006. PMID: 17073000 No abstract available.
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1-year mortality after first hospitalization for heart failure was similar in patients with preserved or reduced ejection fraction.ACP J Club. 2006 Nov-Dec;145(3):78. ACP J Club. 2006. PMID: 17080990 No abstract available.
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1 year mortality after first hospital admission for heart failure was similar in patients with preserved or reduced ejection fraction.Evid Based Med. 2006 Dec;11(6):185. doi: 10.1136/ebm.11.6.185. Evid Based Med. 2006. PMID: 17213179 No abstract available.
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