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Circulation, Vol 88, 107-115, Copyright © 1993 by American Heart Association
KK Ho, KM Anderson, WB Kannel, W Grossman and D Levy
BACKGROUND. Relatively limited epidemiological data are available regarding
the prognosis of congestive heart failure (CHF) and temporal changes in
survival after its onset in a population-based setting. METHODS AND
RESULTS. Proportional hazards models were used to evaluate the effects of
selected clinical variables on survival after the onset of CHF among 652
members of the Framingham Heart Study (51% men; mean age, 70.0 +/- 10.8
years) who developed CHF between 1948 and 1988. Subjects were older at the
diagnosis of heart failure in the later decades of this study (mean age at
heart failure diagnosis, 57.3 +/- 7.6 years in the 1950s, 65.9 +/- 7.9
years in the 1960s, 71.6 +/- 9.4 years in the 1970s, and 76.4 +/- 10.0
years in the 1980s; p < 0.001). Median survival after the onset of heart
failure was 1.7 years in men and 3.2 years in women. Overall, 1-year and
5-year survival rates were 57% and 25% in men and 64% and 38% in women,
respectively. Survival was better in women than in men (age-adjusted
hazards ratio for mortality, 0.64; 95% CI, 0.54-0.77). Mortality increased
with advancing age in both sexes (hazards ratio for men, 1.27 per decade of
age; 95% CI, 1.09- 1.47; hazards ratio for women, 1.61 per decade of age;
95% CI, 1.37- 1.90). Adjusting for age, there was no significant temporal
change in the prognosis of CHF during the 40 years of observation (hazards
ratio for men for mortality, 1.08 per calendar decade; 95% CI, 0.92-1.27;
hazards ratio for women for mortality, 1.02 per calendar decade; 95% CI,
0.83-1.26). CONCLUSIONS. CHF remains highly lethal, with better prognosis
in women and in younger individuals. Advances in the treatment of
hypertension, myocardial ischemia, and valvular heart disease during the
four decades of observation did not translate into appreciable improvements
in overall survival after the onset of CHF in this large, unselected
population.
ARTICLES
Survival after the onset of congestive heart failure in Framingham Heart Study subjects
Cardiovascular Division, Charles A. Dana Research Institute, Boston, MA.
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F. de Giuli, K.-T. Khaw, M. R. Cowie, G. C. Sutton, R. Ferrari, and P. A. Poole-Wilson Incidence and outcome of persons with a clinical diagnosis of heart failure in a general practice population of 696,884 in the United Kingdom Eur J Heart Fail, March 16, 2005; 7(3): 295 - 302. [Abstract] [Full Text] [PDF]
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C. O. Phillips, R. M. Singa, H. R. Rubin, and T. Jaarsma Complexity of program and clinical outcomes of heart failure disease management incorporating specialist nurse-led heart failure clinics. A meta-regression analysis Eur J Heart Fail, March 16, 2005; 7(3): 333 - 341. [Abstract] [Full Text] [PDF]
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D. T.F. Lee, D. S.F. Yu, J. Woo, and D. R. Thompson Health-related quality of life in patients with congestive heart failure Eur J Heart Fail, March 16, 2005; 7(3): 419 - 422. [Abstract] [Full Text] [PDF]
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 M. Enriquez-Sarano, J.-F. Avierinos, D. Messika-Zeitoun, D. Detaint, M. Capps, V. Nkomo, C. Scott, H. V. Schaff, and A. J. Tajik Quantitative Determinants of the Outcome of Asymptomatic Mitral Regurgitation N. Engl. J. Med., March 3, 2005; 352(9): 875 - 883. [Abstract] [Full Text] [PDF]
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P. J. Hauptman and E. P. Havranek Integrating Palliative Care Into Heart Failure Care Arch Intern Med, February 28, 2005; 165(4): 374 - 378. [Abstract] [Full Text] [PDF]
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F. Bursi, M. Enriquez-Sarano, V. T. Nkomo, S. J. Jacobsen, S. A. Weston, R. A. Meverden, and V. L. Roger Heart Failure and Death After Myocardial Infarction in the Community: The Emerging Role of Mitral Regurgitation Circulation, January 25, 2005; 111(3): 295 - 301. [Abstract] [Full Text] [PDF]
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F. Grigioni, D. Detaint, J.-F. Avierinos, C. Scott, J. Tajik, and M. Enriquez-Sarano Contribution of ischemic mitral regurgitation to congestive heart failure after myocardial infarction J. Am. Coll. Cardiol., January 18, 2005; 45(2): 260 - 267. [Abstract] [Full Text] [PDF]
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J. G. Ray, Y. Gong, K. Sykora, and J. V. Tu Statin Use and Survival Outcomes in Elderly Patients With Heart Failure Arch Intern Med, January 10, 2005; 165(1): 62 - 67. [Abstract] [Full Text] [PDF]
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F. Gustafsson, C. B. Kragelund, C. Torp-Pedersen, M. Seibaek, H. Burchardt, D. Akkan, J. J. Thune, L. Kober, and for the DIAMOND study group Effect of obesity and being overweight on long-term mortality in congestive heart failure: influence of left ventricular systolic function Eur. Heart J., January 1, 2005; 26(1): 58 - 64. [Abstract] [Full Text] [PDF]
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W. Jiang, M. Kuchibhatla, M. S. Cuffe, E. J. Christopher, J. D. Alexander, G. L. Clary, M. A. Blazing, L. H. Gaulden, R. M. Califf, R. R. Krishnan, et al. Prognostic Value of Anxiety and Depression in Patients With Chronic Heart Failure Circulation, November 30, 2004; 110(22): 3452 - 3456. [Abstract] [Full Text] [PDF]
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F. H. Gwadry-Sridhar, V. Flintoft, D. S. Lee, H. Lee, and G. H. Guyatt A Systematic Review and Meta-analysis of Studies Comparing Readmission Rates and Mortality Rates in Patients With Heart Failure Arch Intern Med, November 22, 2004; 164(21): 2315 - 2320. [Abstract] [Full Text] [PDF]
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M. Di Bari, C. Pozzi, M. C. Cavallini, F. Innocenti, G. Baldereschi, W. De Alfieri, E. Antonini, R. Pini, G. Masotti, and N. Marchionni The diagnosis of heart failure in the community: Comparative validation of four sets of criteria in unselected older adults: the ICARe Dicomano Study J. Am. Coll. Cardiol., October 19, 2004; 44(8): 1601 - 1608. [Abstract] [Full Text] [PDF]
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E. R. Perna, S. M. Macin, J. P. C. Canella, N. Augier, J. L. R. Stival, J. R. Cialzeta, A. E. Pitzus, E. H. Garcia, R. Obregon, M. Brizuela, et al. Ongoing Myocardial Injury in Stable Severe Heart Failure: Value of Cardiac Troponin T Monitoring for High-Risk Patient Identification Circulation, October 19, 2004; 110(16): 2376 - 2382. [Abstract] [Full Text] [PDF]
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F. Gustafsson, C. Torp-Pedersen, M. Seibaek, H. Burchardt, L. Kober, and for the DIAMOND study group Effect of age on short and long-term mortality in patients admitted to hospital with congestive heart failure Eur. Heart J., October 1, 2004; 25(19): 1711 - 1717. [Abstract] [Full Text] [PDF]
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 G. D. Schellenbaum, T. D. Rea, S. R. Heckbert, N. L. Smith, T. Lumley, V. L. Roger, D. W. Kitzman, H. A. Taylor, D. Levy, and B. M. Psaty Survival Associated with Two Sets of Diagnostic Criteria for Congestive Heart Failure Am. J. Epidemiol., October 1, 2004; 160(7): 628 - 635. [Abstract] [Full Text] [PDF]
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F. Ceia, C. Fonseca, T. Mota, H. Morais, F. Matias, C. Costa, and A. G. Oliveira Aetiology, comorbidity and drug therapy of chronic heart failure in the real world: the EPICA substudy Eur J Heart Fail, October 1, 2004; 6(6): 801 - 806. [Abstract] [Full Text] [PDF]
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L. Barki-Harrington, C. Perrino, and H. A Rockman Network integration of the adrenergic system in cardiac hypertrophy Cardiovasc Res, August 15, 2004; 63(3): 391 - 402. [Abstract] [Full Text] [PDF]
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F D R Hobbs, R C Davis, A K Roalfe, R Hare, and M K Davies Reliability of N-terminal proBNP assay in diagnosis of left ventricular systolic dysfunction within representative and high risk populations Heart, August 1, 2004; 90(8): 866 - 870. [Abstract] [Full Text] [PDF]
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I. Raymond, J. Mehlsen, F. Pedersen, J. Dimsits, J. Jacobsen, and P. R. Hildebrandt The prognosis of impaired left ventricular systolic function and heart failure in a middle-aged and elderly population in an urban population segment of Copenhagen Eur J Heart Fail, August 1, 2004; 6(5): 653 - 661. [Abstract] [Full Text] [PDF]
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V. L. Roger, S. A. Weston, M. M. Redfield, J. P. Hellermann-Homan, J. Killian, B. P. Yawn, and S. J. Jacobsen Trends in Heart Failure Incidence and Survival in a Community-Based Population JAMA, July 21, 2004; 292(3): 344 - 350. [Abstract] [Full Text] [PDF]
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S. Bergeron, S. R. Ommen, K. R. Bailey, J. K. Oh, R. B. McCully, and P. A. Pellikka Exercise echocardiographic findings and outcome of patients referred for evaluation of dyspnea J. Am. Coll. Cardiol., June 16, 2004; 43(12): 2242 - 2246. [Abstract] [Full Text] [PDF]
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S. Z. Pantilat and A. E. Steimle Palliative Care for Patients With Heart Failure JAMA, May 26, 2004; 291(20): 2476 - 2482. [Abstract] [Full Text] [PDF]
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M. Jessup and I. L. Pina Is it important to examine gender differences in the epidemiology and outcome of severe heart failure? J. Thorac. Cardiovasc. Surg., May 1, 2004; 127(5): 1247 - 1252. [Full Text] [PDF]
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