More 'malignant' than cancer? Five-year survival following a first admission for heart failure.
BACKGROUND
The prognostic impact of heart failure relative to that of 'high-profile' disease states such as cancer, within the whole population, is unknown.


METHODS
All patients with a first admission to any Scottish hospital in 1991 for heart failure, myocardial infarction or the four most common types of cancer specific to men and women were identified. Five-year survival rates and associated loss of expected life-years were then compared.


RESULTS
In 1991, 16224 men had an initial hospitalisation for heart failure (n=3241), myocardial infarction (n=6932) or cancer of the lung, large bowel, prostate or bladder (n=6051). Similarly, 14842 women were admitted for heart failure (n=3606), myocardial infarction (n=4916), or cancer of the breast, lung, large bowel or ovary (n=6320). With the exception of lung cancer, heart failure was associated with the poorest 5-year survival rate (approximately 25% for both sexes). On an adjusted basis, heart failure was associated with worse long-term survival than bowel cancer in men (adjusted odds ratio, 0.89; 95% CI, 0.82-0.97; P<0.01) and breast cancer in women (odds ratio, 0.59; 95% CI, 0.55-0.64; P<0.001). The overall population rate of expected life-years lost due to heart failure in men was 6.7 years/1000 and for women 5.1 years/1000.


CONCLUSIONS
With the notable exception of lung cancer, heart failure is as 'malignant' as many common types of cancer and is associated with a comparable number of expected life-years lost.
Stewart
S
S
Clinical Research Initiative in Heart Failure, University of Glasgow, G12 8QQ, Glasgow, UK.
MacIntyre
K
K
Hole
D J
DJ
Capewell
S
S
McMurray
J J
JJ
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000150:complications / Q000453:epidemiology / Q000401:mortality; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000150:complications* / Q000453:epidemiology / Q000401:mortality*; D006801:Humans; D008017:Life Expectancy; D008175:Lung Neoplasms / Q000150:complications / Q000453:epidemiology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000453:epidemiology / Q000401:mortality; D009369:Neoplasms / Q000150:complications* / Q000453:epidemiology / Q000401:mortality*; D010051:Ovarian Neoplasms / Q000150:complications / Q000453:epidemiology / Q000401:mortality; D010343:Patient Admission; D012189:Retrospective Studies; D012606:Scotland / Q000453:epidemiology; D012737:Sex Factors; D016019:Survival Analysis; D015996:Survival Rate