Abstract 14991: Long-term Mortality and Morbidity Trends in Men and Women with Heart Failure of Ischemic versus Non-ischemic Etiology in Western Australia between 1990 and 2005
Background: It is uncertain if improvements in long-term mortality and morbidity after new-onset heart failure (HF) have occurred in both men and women with ischemic and non-ischemic forms of HF.
Methods: The Western Australia Hospital Morbidity Database was used to identify all patients hospitalized for first (index) HF between 1990 and 2005. Patients were followed until death or censored on December 31, 2006 to determine 5-year survival. Cox proportional hazards models were used to compare the adjusted hazard ratios (HR) during the study period (4-year periods with 1990-1993 as the baseline).
Results: A total of 21,507 index HF patients (mean age 73.9 years, 49.1% women) were identified. Prior or coexistent ischemic heart disease (IHD) was present in 42.5% of cases. Women were significantly older than men, and less likely to have ischemic HF (38.8% vs 46.1%). Over the period, the age-standardized incidence of first HF hospitalization declined but with the least decline occurring in women with non-ischemic HF (-13.3%) compared to other subgroups. Risk-adjusted 5-year mortality declined over the study period (HR 0.58, 95% CI 0.51-0.67) for patients admitted in 1998-2001 compared with 1990-1993. A significant improvement in 5-year adjusted mortality was seen in both forms of HF, and in both sexes and across all age groups. Total non-elective hospitalizations for HF increased over the period (+14.9%), particularly for non-ischemic HF (+25.9%), of which elderly women formed the predominant group. Overall burden of non-elective hospitalization for HF was 48.5% higher in the non-ischemic versus ischemic sub-group (285,905 vs 192,540 person-days, p<0.001).
Conclusions: Risk-adjusted long-term survival improved similarly in men and women with ischemic and non-ischemic forms of HF, including the elderly, during 1990-2005 in Western Australia. However, there was a growing burden of HF hospitalizations particularly for persons with HF of non-ischemic etiology.
- © 2010 by American Heart Association, Inc.