Donate Help Contact The AHA Sign In Home
American Heart Association
Circulation
Search: search_blue_button Advanced Search
Circulation. 2007;116:1482-1487
Published online before print August 27, 2007, doi: 10.1161/CIRCULATIONAHA.107.696906
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow CME: Take the course for this article:
Circulation: September 25, 2007, Volume 116, Number 13
Right arrow All Versions of this Article:
116/13/1482    most recent
CIRCULATIONAHA.107.696906v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Solomon, S. D.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Solomon, S. D.
Right arrowPubmed/NCBI databases
*Compound via MeSH
*Substance via MeSH
Medline Plus Health Information
*Heart Failure
Related Collections
Right arrow Other heart failure
Right arrow Congestive
Right arrow Epidemiology

(Circulation. 2007;116:1482-1487.)
© 2007 American Heart Association, Inc.


Heart Failure

Influence of Nonfatal Hospitalization for Heart Failure on Subsequent Mortality in Patients With Chronic Heart Failure

Scott D. Solomon, MD; Joanna Dobson, MSc; Stuart Pocock, PhD; Hicham Skali, MD; John J.V. McMurray, MD; Christopher B. Granger, MD; Salim Yusuf, MD, DPhil; Karl Swedberg, MD, PhD; James B. Young, MD; Eric L. Michelson, MD; Marc A. Pfeffer, MD, PhD, for the Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity (CHARM) Investigators

From the Cardiovascular Division (S.D.S., H.S., M.A.P), Department of Medicine, Brigham and Women’s Hospital, Boston, Mass; University of Glasgow (J.J.V.M.), Glasgow, UK; AstraZeneca LP (E.L.M.), Wilmington, Del; Sahlgrenska University, Hospital/Östra (K.S.), Göteborg, Sweden; Duke University Medical Center, (C.G.), Durham, NC; Hamilton Health Sciences and McMaster University (S.Y.), Hamilton, Ontario, Canada; Cleveland Clinic Foundation (J.B.Y.), Cleveland, Ohio; and London School of Hygiene (S.P., J.D.), London, UK.

Correspondence to Scott D. Solomon, MD, Cardiovascular Division, Brigham and Women’s Hospital, 75 Francis St, Boston, MA 02115. E-mail ssolomon{at}rics.bwh.harvard.edu

Received February 15, 2007; accepted July 10, 2007.

Background— Patients with chronic heart failure (HF) are at increased risk of both fatal and nonfatal major adverse cardiovascular events. We used data from the Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity (CHARM) trials to assess the influence of nonfatal hospitalizations for HF on subsequent mortality rates in a broad spectrum of HF patients.

Methods and Results— In the present study, 7599 patients with New York Heart Association class II to IV HF and reduced or preserved left ventricular ejection fraction were randomized to placebo or candesartan. We assessed the risk of death after discharge from a first hospitalization for HF using time-updated Cox proportional-hazards models on 7572 patients for whom discharge data were available. Of 7572 patients, 1455 (19%) had at least 1 HF hospitalization, and 586 of 1819 deaths occurred after discharge from an HF hospitalization. The mortality rate was increased after HF hospitalizations, even after adjustment for baseline predictors of death (hazard ratio, 3.15; 95% confidence interval, 2.83 to 3.50). Longer duration of HF hospitalization enhanced the risk of dying, as did repeat HF hospitalizations. Moreover, risk of death was highest within a month of discharge and then declined progressively over time, particularly for death resulting from HF progression and for sudden cardiac death. We observed a similar pattern of risk associated with all-cause hospitalization, although the magnitude was less than that with HF hospitalization.

Conclusions— In patients with chronic HF, the risk of death is greatest in the early period after discharge after a hospitalization for HF and is directly related to the duration and frequency of HF hospitalizations. These findings suggest a role for increased surveillance in the early postdischarge period of greatest vulnerability after an HF admission.


 

CLINICAL PERSPECTIVE




This article has been cited by other articles:


Home page
Eur Heart JHome page
G. Breithardt
MADIT-CRT (Multicenter Automatic Defibrillator Implantation Trial-Cardiac Resynchronization Therapy): cardiac resynchronization therapy towards early management of heart failure
Eur. Heart J., November 1, 2009; 30(21): 2551 - 2553.
[Full Text] [PDF]


Home page
J Am Coll CardiolHome page
S. M. Dunlay, M. M. Redfield, S. A. Weston, T. M. Therneau, K. Hall Long, N. D. Shah, and V. L. Roger
Hospitalizations after heart failure diagnosis a community perspective.
J. Am. Coll. Cardiol., October 27, 2009; 54(18): 1695 - 1702.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
S. Setoguchi and L. W. Stevenson
Hospitalizations in patients with heart failure: who and why.
J. Am. Coll. Cardiol., October 27, 2009; 54(18): 1703 - 1705.
[Full Text] [PDF]


Home page
J Am Coll CardiolHome page
J. J.V. McMurray, C. B. Granger, J. Ostergren, S. Yusuf, M. A. Pfeffer, and K. Swedberg
Dual Renin-Angiotensin system blockade in heart failure.
J. Am. Coll. Cardiol., July 14, 2009; 54(3): 278 - 278.
[Full Text] [PDF]


Home page
Am J Crit CareHome page
E. K. Song, D. K. Moser, and T. A. Lennie
Relationship of Depressive Symptoms to the Impact of Physical Symptoms on Functional Status in Women With Heart Failure
Am. J. Crit. Care., July 1, 2009; 18(4): 348 - 356.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
S. A. Hunt, W. T. Abraham, M. H. Chin, A. M. Feldman, G. S. Francis, T. G. Ganiats, M. Jessup, M. A. Konstam, D. M. Mancini, K. Michl, et al.
2009 Focused Update Incorporated Into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines Developed in Collaboration With the International Society for Heart and Lung Transplantation
J. Am. Coll. Cardiol., April 14, 2009; 53(15): e1 - e90.
[Full Text] [PDF]


Home page
J Am Coll CardiolHome page
M. Jessup, W. T. Abraham, D. E. Casey, A. M. Feldman, G. S. Francis, T. G. Ganiats, M. A. Konstam, D. M. Mancini, P. S. Rahko, M. A. Silver, et al.
2009 Focused Update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines Developed in Collaboration With the International Society for Heart and Lung Transplantation
J. Am. Coll. Cardiol., April 14, 2009; 53(15): 1343 - 1382.
[Full Text] [PDF]


Home page
CirculationHome page
2009 WRITING GROUP TO REVIEW NEW EVIDENCE AND UPDA, M. Jessup, W. T. Abraham, D. E. Casey, A. M. Feldman, G. S. Francis, T. G. Ganiats, M. A. Konstam, D. M. Mancini, P. S. Rahko, et al.
2009 Focused Update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: Developed in Collaboration With the International Society for Heart and Lung Transplantation
Circulation, April 14, 2009; 119(14): 1977 - 2016.
[Full Text] [PDF]


Home page
CirculationHome page
2005 WRITING COMMITTEE MEMBERS, S. A. Hunt, W. T. Abraham, M. H. Chin, A. M. Feldman, G. S. Francis, T. G. Ganiats, M. Jessup, M. A. Konstam, D. M. Mancini, et al.
2009 Focused Update Incorporated Into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: Developed in Collaboration With the International Society for Heart and Lung Transplantation
Circulation, April 14, 2009; 119(14): e391 - e479.
[Full Text] [PDF]


Home page
J Am Coll CardiolHome page
M. Gheorghiade and P. S. Pang
Acute heart failure syndromes.
J. Am. Coll. Cardiol., February 17, 2009; 53(7): 557 - 573.
[Abstract] [Full Text] [PDF]


Home page
Eur Heart JHome page
P. Abrahamsson, J. Dobson, C. B. Granger, J. J.V. McMurray, E. L. Michelson, M. Pfeffer, S. Pocock, S. D. Solomon, S. Yusuf, K. Swedberg, et al.
Impact of hospitalization for acute coronary events on subsequent mortality in patients with chronic heart failure
Eur. Heart J., February 1, 2009; 30(3): 338 - 345.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
J. D. Flaherty, J. J. Bax, L. De Luca, J. S. Rossi, C. J. Davidson, G. Filippatos, P. P. Liu, M. A. Konstam, B. Greenberg, M. R. Mehra, et al.
Acute heart failure syndromes in patients with coronary artery disease early assessment and treatment.
J. Am. Coll. Cardiol., January 20, 2009; 53(3): 254 - 263.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
J. A. Ezekowitz, P. Kaul, J. A. Bakal, P. W. Armstrong, R. C. Welsh, and F. A. McAlister
Declining in-hospital mortality and increasing heart failure incidence in elderly patients with first myocardial infarction.
J. Am. Coll. Cardiol., January 6, 2009; 53(1): 13 - 20.
[Abstract] [Full Text] [PDF]


Home page
ESC Textbook of Cardiovascular MedicineHome page
J. McMurray, M. Petrie, K. Swedberg, M. Komajda, S. Anker, and R. Gardner
CHAPTER 23 Heart Failure
ESC Textbook of Cardiovascular Medicine, January 1, 2009; 2(1): med-9780199566990-chapter - med-9780199566990-chapter.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
J. E.A. Blair, F. Zannad, M. A. Konstam, T. Cook, B. Traver, J. C. Burnett Jr, L. Grinfeld, H. Krasa, A. P. Maggioni, C. Orlandi, et al.
Continental Differences in Clinical Characteristics, Management, and Outcomes in Patients Hospitalized With Worsening Heart Failure: Results From the EVEREST (Efficacy of Vasopressin Antagonism in Heart Failure: Outcome Study with Tolvaptan) Program
J. Am. Coll. Cardiol., November 11, 2008; 52(20): 1640 - 1648.
[Abstract] [Full Text] [PDF]


Home page
Eur J Heart FailHome page
A. Arya, M. Block, J. Kautzner, T. Lewalter, H. Mortel, S. Sack, B. Schumacher, P. Sogaard, M. Taborsky, D. Husser, et al.
Influence of Home Monitoring on the clinical status of heart failure patients: Design and rationale of the IN-TIME study
Eur J Heart Fail, November 1, 2008; 10(11): 1143 - 1148.
[Abstract] [Full Text] [PDF]


Home page
JAMAHome page
M. Gheorghiade, N. C. Wang, and T. Cook
QRS Duration in Patients Hospitalized for Worsening Heart Failure--Reply
JAMA, October 22, 2008; 300(16): 1880 - 1881.
[Full Text] [PDF]


Home page
Eur J Heart FailHome page
F. Braunschweig, I. Ford, V. Conraads, M. R. Cowie, G. Jondeau, J. Kautzner, M. Lunati, R. M. Aguilera, C. M. Yu, M. Marijianowski, et al.
Can monitoring of intrathoracic impedance reduce morbidity and mortality in patients with chronic heart failure? Rationale and design of the Diagnostic Outcome Trial in Heart Failure (DOT-HF)
Eur J Heart Fail, September 1, 2008; 10(9): 907 - 916.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
J. Butler and A. Kalogeropoulos
Worsening Heart Failure Hospitalization Epidemic: We Do Not Know How to Prevent and We Do Not Know How to Treat!
J. Am. Coll. Cardiol., August 5, 2008; 52(6): 435 - 437.
[Full Text] [PDF]


Home page
J Am Coll CardiolHome page
W. T. Abraham, G. C. Fonarow, N. M. Albert, W. G. Stough, M. Gheorghiade, B. H. Greenberg, C. M. O'Connor, J. L. Sun, C. W. Yancy, J. B. Young, et al.
Predictors of In-Hospital Mortality in Patients Hospitalized for Heart Failure: Insights From the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE-HF)
J. Am. Coll. Cardiol., July 29, 2008; 52(5): 347 - 356.
[Abstract] [Full Text] [PDF]


Home page
CirculationHome page
P. Hoglund and L. A. F. Nilsson
Letter by Hoglund and Nilsson Regarding Article, "Influence of Nonfatal Hospitalization for Heart Failure on Subsequent Mortality in Patients With Chronic Heart Failure"
Circulation, July 1, 2008; 118(1): e7 - e7.
[Full Text] [PDF]


Home page
CirculationHome page
S. D. Solomon, M. A. Pfeffer, S. Pocock, J. Marro, J. J.V. McMurray, C. B. Granger, S. Yusuf, K. Swedberg, J. B. Young, E. Michelson, et al.
Response to Letter Regarding Article, "Influence of Nonfatal Hospitalization for Heart Failure on Subsequent Mortality in Patients With Chronic Heart Failure"
Circulation, July 1, 2008; 118(1): e8 - e8.
[Full Text] [PDF]


Home page
JAMAHome page
N. C. Wang, A. P. Maggioni, M. A. Konstam, F. Zannad, H. B. Krasa, J. C. Burnett Jr, L. Grinfeld, K. Swedberg, J. E. Udelson, T. Cook, et al.
Clinical Implications of QRS Duration in Patients Hospitalized With Worsening Heart Failure and Reduced Left Ventricular Ejection Fraction
JAMA, June 11, 2008; 299(22): 2656 - 2666.
[Abstract] [Full Text] [PDF]


Home page
Journal Watch CardiologyHome page
Heart Failure Hospitalizations and Mortality
Journal Watch Cardiology, October 17, 2007; 2007(1017): 4 - 4.
[Full Text]