Improving survival in the 6 months after diagnosis of heart failure in the past decade: population-based data from the UK.
OBJECTIVE
To investigate the secular trend in survival after a new diagnosis of heart failure in the UK population.


METHODS
Comparison of all-cause mortality in the 6 months after diagnosis of heart failure in population-based studies in the south east of England in 2004-5 (Hillingdon-Hastings Study) and 1995-7 (Hillingdon-Bromley Studies).


METHODS
396 patients in the 2004-5 cohort and 552 patients in the 1995-7 cohort with incident (new) heart failure.


METHODS
All-cause mortality.


RESULTS
All-cause mortality rates were 6% (95% CI 3% to 8%) at 1 month, 11% (8% to 14%) at 3 months and 14% (11% to 18%) at 6 months in the 2004-5 cohort compared with 16% (13% to 20%), 22% (19% to 25%) and 26% (22% to 29%), respectively, in the 1995-7 cohort (difference between the two cohorts, p<0.001). The difference in survival was not explained by any difference in the demographics or severity of heart failure at presentation. There was a difference at baseline and thereafter in the use of neurohormonal antagonists (beta-blockers and angiotensin-converting enzyme inhibitors).


CONCLUSIONS
Although early mortality remains high among patients with newly diagnosed heart failure in the UK general population, there is strong evidence of a marked improvement in survival from 1995-7 to 2004-5, perhaps partly explained by an increased usage of neurohormonal antagonists.
Mehta
P A
PA
Imperial College, London, UK.
Dubrey
S W
SW
McIntyre
H F
HF
Walker
D M
DM
Hardman
S M C
SM
Sutton
G C
GC
McDonagh
T A
TA
Cowie
Martin R
MR
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D005260:Female; D006333:Heart Failure / Q000188:drug therapy / Q000401:mortality*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D015996:Survival Rate; D006113:United Kingdom / Q000453:epidemiology
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors