title: [Prognostic factors and long-term survival after initial diagnosis of heart failure].
abstract: OBJECTIVE
  To assess long-term mortality and prognostic factors after initial diagnosis of heart failure (HF), to analyze the differences in function of the left ventricular ejection fraction (preserved [HFPEF] vs. systolic dysfunction [HFSD]) and to compare the results with the main series of incident cases of HF published.
  
  
  METHODS
  Retrospective cohort study including patients first diagnosed of heart failure (Framingham criteria), between 1-01-1997 and 31-12-2001, classified according to a left ventricle ejection fraction (LVEF) above or equal to 50% (HFPEF) or below 50% (HFSD). Follow-up of patients was conducted during ten years.
  
  
  RESULTS
  Out of 400 incident cases of heart failure, 231 patients (57,7%) presented with HFPEF. At 10 years, mortality rates were higher in the HFSD group (64,5 vs. 55,4%, p=0,04). Following a multi-variant analysis, HFPEF mortality was related with age, diabetes mellitus, ischemic heart disease, and chronic renal failure. Treatment with statins and beta-blockers was associated with improved prognosis. Among patients with HFSD, mortality predictors were similar, although patients treated with statins did not show higher survival rates. For other series of incident cases, there were differences in variables related to prognosis and mortality of patients.
  
  
  CONCLUSIONS
  After an initial diagnosis of HF, more than half of patients die within 10 years of monitoring. Age, diabetes mellitus, ischemic heart disease and chronic renal failure are all associated with worse prognosis in these patients, whereas the use of beta-blockers and statins is associated with a better prognosis.
authors.affiliation: Unidad de Medicina Interna, Área de Medicina, Hospital Costa del Sol, Marbella, Málaga, España. quiroslopez77@gmail.com
authors.forename: Raúl
authors.initials: R
authors.lastname: Quirós López
authors.forename: Javier
authors.initials: J
authors.lastname: García Alegría
authors.forename: María Dolores
authors.initials: MD
authors.lastname: Martín Escalante
authors.forename: Javier
authors.initials: J
authors.lastname: Trujillo Santos
authors.forename: María Ángeles
authors.initials: MÁ
authors.lastname: Villena Ruiz
authors.forename: Emilio
authors.initials: E
authors.lastname: Perea Milla
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality* / Q000503:physiopathology; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013318:Stroke Volume; D016019:Survival Analysis; D016277:Ventricular Function, Left
chemical_list: D000319:Adrenergic beta-Antagonists; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors