title: Temporal trends in long-term mortality of patients with acute heart failure: Data from 1985-2008.
abstract: BACKGROUND
  Heart failure (HF) has a poor prognosis. Patients with acute heart failure in particular have a high risk of dying. However, there is a lack of data regarding their long-term mortality and changes there-in with time. The aim of our study was to describe trends in short- and long-term mortality of patients hospitalized with acute HF in the period from 1985 through 2008. In addition, we determined the prognostic worth of the aetiology of HF.
  
  
  RESULTS
  We included a consecutive series of 1810 patients with acute HF in this prospective registry in the period of 1985 through 2008. The cumulative one-year mortality rate of the patients was 35%. The short-term prognosis remained unchanged over the decades. However, the cumulative mortality rate ten years after admission was lowest in the last decade (73% in 2000-2008 vs. 78% in 1985-1999, p=0.001). After multivariable adjustment, the ten-year mortality rate was lower in the last decade as compared to the first decade (hazard ratio (HR) 0.83; 95% confidence interval (CI) 0.71-0.96). Ischemic cardiomyopathy was associated with a higher mortality (HR 1.32; 95% CI 1.12-1.54) when compared to other causes of HF.
  
  
  CONCLUSIONS
  Patients admitted with acute HF were found to have both high short-term and long-term mortality. Long-term prognostic improvement in the last decade was observed among patients with a reduced ejection fraction. While patients with HF due to valvular heart disease had the best prognosis, an ischemic aetiology of HF was associated with the worst outcome.
authors.affiliation: Department of Cardiology, Thoraxcentre, Erasmus Medical Centre, Rotterdam, The Netherlands.
authors.forename: Jan C
authors.initials: JC
authors.lastname: van den Berge
authors.affiliation: Department of Cardiology, Thoraxcentre, Erasmus Medical Centre, Rotterdam, The Netherlands.
authors.forename: Martijn K
authors.initials: MK
authors.lastname: Akkerhuis
authors.affiliation: Department of Cardiology, Thoraxcentre, Erasmus Medical Centre, Rotterdam, The Netherlands.
authors.forename: Alina A
authors.initials: AA
authors.lastname: Constantinescu
authors.affiliation: Department of Medical Informatics, Erasmus University Medical Centre, Rotterdam, The Netherlands.
authors.forename: Jan A
authors.initials: JA
authors.lastname: Kors
authors.affiliation: Department of Cardiology, Thoraxcentre, Erasmus Medical Centre, Rotterdam, The Netherlands.
authors.forename: Ron T
authors.initials: RT
authors.lastname: van Domburg
authors.affiliation: Department of Cardiology, Thoraxcentre, Erasmus Medical Centre, Rotterdam, The Netherlands. Electronic address: j.deckers@erasmusmc.nl.
authors.forename: Jaap W
authors.initials: JW
authors.lastname: Deckers
mesh_terms: D000208:Acute Disease; D000368:Aged; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D000069451:Long Term Adverse Effects / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D017202:Myocardial Ischemia / Q000453:epidemiology*; D009426:Netherlands / Q000453:epidemiology; D011379:Prognosis; D011446:Prospective Studies; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D013318:Stroke Volume
keywords: Acute heart failure; Epidemiology; Mortality; Trends