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Trends in long-term cardiovascular mortality and morbidity in men and women with heart failure of ischemic versus non-ischemic aetiology in Western Australia between 1990 and 2005

Journal Article


Abstract


  • Background: It is uncertain if improvements in long-term cardiovascular (CV) mortality have occurred in both men and women with ischemic and non-ischemic forms of heart failure (HF). Methods: The Western Australia Hospital Morbidity Database was used to identify all index (first-ever) hospitalizations for HF between 1990 and 2005. Patients were followed until death attributed to cardiovascular causes or censored on December 31, 2006 to determine 5-year survival. Cox proportional hazards models were used to compare the adjusted mortality hazard ratio (HR) during the study follow-up (4-year periods).

    Results: A total of 21,507 patients (mean age 73.9 years, 49.1% women) were identified. Women were significantly older than men, and less likely to have ischemic HF (38.8% versus 46.1%). Over the period, age-standardized incidence of first HF hospitalization declined but with the least decline in women with non-ischemic HF (- 13.3%) compared to other subgroups. Risk-adjusted 5-year CV mortality declined over the study period, with HR 0.64 (95% CI 0.60-0.68) for patients admitted in 1998-2001 compared to 1990-1993, with significant improvement in both forms of HF, and in both sexes and across age groups. However, overall total HF hospitalizations increased (+ 26.7%) over the period, particularly for non-ischemic HF (+ 43.7%), of which elderly women formed the predominant group.

    Conclusions: Risk-adjusted long-term survival improved similarly in men and women, including the elderly, with ischemic and non-ischemic forms of HF during 1990-2005 in Western Australia. However, there was a growing burden of HF hospitalizations particularly for HF of non-ischemic aetiology.

Authors


  •   Teng, Tiew-Hwa Katherine (external author)
  •   Hung, Joseph (external author)
  •   Knuiman, Matthew (external author)
  •   Stewart, Simon (external author)
  •   Arnolda, Leonard F.
  •   Jacobs, Ian (external author)
  •   Hobbs, Michael (external author)
  •   Sanfilippo, F M. (external author)
  •   Geelhoed, Elizabeth (external author)
  •   Finn, Judith (external author)

Publication Date


  • 2011

Citation


  • Teng, T., Hung, J., Knuiman, M., Stewart, S., Arnolda, L., Jacobs, I., Hobbs, M., Sanfilippo, F., Geelhoed, E. & Finn, J. (2012). Trends in long-term cardiovascular mortality and morbidity in men and women with heart failure of ischemic versus non-ischemic aetiology in Western Australia between 1990 and 2005. International Journal of Cardiology, 158 (3), 405-410.

Scopus Eid


  • 2-s2.0-84863626168

Ro Metadata Url


  • http://ro.uow.edu.au/ihmri/785

Has Global Citation Frequency


Number Of Pages


  • 5

Start Page


  • 405

End Page


  • 410

Volume


  • 158

Issue


  • 3

Place Of Publication


  • Ireland

Abstract


  • Background: It is uncertain if improvements in long-term cardiovascular (CV) mortality have occurred in both men and women with ischemic and non-ischemic forms of heart failure (HF). Methods: The Western Australia Hospital Morbidity Database was used to identify all index (first-ever) hospitalizations for HF between 1990 and 2005. Patients were followed until death attributed to cardiovascular causes or censored on December 31, 2006 to determine 5-year survival. Cox proportional hazards models were used to compare the adjusted mortality hazard ratio (HR) during the study follow-up (4-year periods).

    Results: A total of 21,507 patients (mean age 73.9 years, 49.1% women) were identified. Women were significantly older than men, and less likely to have ischemic HF (38.8% versus 46.1%). Over the period, age-standardized incidence of first HF hospitalization declined but with the least decline in women with non-ischemic HF (- 13.3%) compared to other subgroups. Risk-adjusted 5-year CV mortality declined over the study period, with HR 0.64 (95% CI 0.60-0.68) for patients admitted in 1998-2001 compared to 1990-1993, with significant improvement in both forms of HF, and in both sexes and across age groups. However, overall total HF hospitalizations increased (+ 26.7%) over the period, particularly for non-ischemic HF (+ 43.7%), of which elderly women formed the predominant group.

    Conclusions: Risk-adjusted long-term survival improved similarly in men and women, including the elderly, with ischemic and non-ischemic forms of HF during 1990-2005 in Western Australia. However, there was a growing burden of HF hospitalizations particularly for HF of non-ischemic aetiology.

Authors


  •   Teng, Tiew-Hwa Katherine (external author)
  •   Hung, Joseph (external author)
  •   Knuiman, Matthew (external author)
  •   Stewart, Simon (external author)
  •   Arnolda, Leonard F.
  •   Jacobs, Ian (external author)
  •   Hobbs, Michael (external author)
  •   Sanfilippo, F M. (external author)
  •   Geelhoed, Elizabeth (external author)
  •   Finn, Judith (external author)

Publication Date


  • 2011

Citation


  • Teng, T., Hung, J., Knuiman, M., Stewart, S., Arnolda, L., Jacobs, I., Hobbs, M., Sanfilippo, F., Geelhoed, E. & Finn, J. (2012). Trends in long-term cardiovascular mortality and morbidity in men and women with heart failure of ischemic versus non-ischemic aetiology in Western Australia between 1990 and 2005. International Journal of Cardiology, 158 (3), 405-410.

Scopus Eid


  • 2-s2.0-84863626168

Ro Metadata Url


  • http://ro.uow.edu.au/ihmri/785

Has Global Citation Frequency


Number Of Pages


  • 5

Start Page


  • 405

End Page


  • 410

Volume


  • 158

Issue


  • 3

Place Of Publication


  • Ireland