Long-term outcome after a first episode of heart failure. A prospective 7-year study.
BACKGROUND
Heart failure (HF) is a major issue of public health in contemporary aging populations. The objectives of the present study were to assess the long-term survival of a contemporary cohort of patients discharged after a first hospitalization for HF and identify variables associated with adverse outcome.


METHODS
We prospectively included consecutive patients (n=735) discharged from 11 healthcare establishments of the Somme department (France) after a first hospitalization for HF during 2000. The 7-year observed survival was compared with the expected survival of the general population.


RESULTS
Mean age of the study group was 75+/-12 years and 48% of patients were women. Left ventricular ejection fraction was measured in 628 patients (85%). During the 7-year follow-up, 483 patients (67%) died. The 5- and 7-year observed survival rates were dramatically lower than the expected survival of the matched general population (42% vs. 70%, and 33% vs. 59%, respectively). Relative survival (observed/expected survival) was 60% at 5 years and 55% at 7 years. Multivariable analysis identified cancer, stroke, diabetes, prior myocardial infarction, chronic obstructive pulmonary disease, chronic atrial fibrillation, age, and hyponatraemia as independent predictors of 7-year mortality.


CONCLUSIONS
In Europe, the long-term outcome of patients with new-onset HF is still extremely poor. Better implementation of guideline-oriented therapeutic strategies is needed to improve prognosis of this increasingly prevalent condition.
Tribouilloy
Christophe
C
INSERM, ERI 12, Amiens, France and University Hospital Amiens, France. tribouilloy.christophe@chu-amiens.fr
Buiciuc
Otilia
O
Rusinaru
Dan
D
Malaquin
Dorothée
D
Lévy
Franck
F
Peltier
Marcel
M
D000368:Aged; D002423:Cause of Death; D005260:Female; D005602:France / Q000453:epidemiology; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology / Q000401:mortality*; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D015996:Survival Rate