title: Heart failure in young adults: 20-year trends in hospitalization, aetiology, and case fatality in Sweden.
abstract: OBJECTIVE
  To describe trends in incidence and case fatality among younger (18-54 years) and older (55-84 years) Swedish patients with heart failure (HF).
  
  
  RESULTS
  Through linking the Swedish national hospital discharge and the cause-specific death registries, we identified patients aged 18-84 years that were discharged 1987-2006 with a diagnosis of HF. Age-specific mean incidence rates per 100 000 person-years were calculated in four 5-year periods. Kaplan-Meier survival curves were plotted up to 3 years. From 1987 to 2006, there were 443 995 HF hospitalizations among adults 18-84 years. Of these, 4660 (1.0%) and 13 507 (3.0%) occurred in people aged 18-44 and 45-54 years (31.6% women), respectively. From the first to the last 5-year period, HF incidence increased by 50 and 43%, among people aged 18-34 and 35-44 years, respectively. Among people ≥45 years, incidence peaked in the mid-1990s and then decreased. Heart failure in the presence of cardiomyopathy increased more than two-fold among all age groups. Case fatality decreased for all age groups until 2001, after which no further significant decrease <55 years was observed.
  
  
  CONCLUSIONS
  Increasing HF hospitalization in young adults in Sweden opposes the general trend seen in older patients, a finding which may reflect true epidemiological changes. Cardiomyopathy accounted for a substantial part of this increase. High case fatality and lack of further case fatality reduction after 2001 are causes for concern.
authors.affiliation: Department of Molecular and Clinical Medicine, Institute of Medicine/Cardiology, Sahlgrenska Academy, University of Gothenburg, Östra, Gothenburg SE-416 85, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Barasa
authors.forename: Maria
authors.initials: M
authors.lastname: Schaufelberger
authors.forename: Georgios
authors.initials: G
authors.lastname: Lappas
authors.forename: Karl
authors.initials: K
authors.lastname: Swedberg
authors.forename: Mikael
authors.initials: M
authors.lastname: Dellborg
authors.forename: Annika
authors.initials: A
authors.lastname: Rosengren
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004812:Epidemiologic Methods; D005260:Female; D006333:Heart Failure / Q000209:etiology / Q000401:mortality*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D013548:Sweden / Q000453:epidemiology
keywords: Comorbidity; Heart failure; Incidence; Prognosis; Young adults
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