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The clinical burden of newly diagnosed Heart failure among patients with Reduced, mildly Reduced, and preserved ejection fraction
BACKGROUND: Contemporary analyses of the distribution of heart failure (HF) patients by groups of ejection fraction are not available or are limited to hospitalized patients. Our objective was to quantify the per-person and system level clinical burden of a broad population of HF patients. METHODS:...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10424074/ https://www.ncbi.nlm.nih.gov/pubmed/37583714 http://dx.doi.org/10.1016/j.ijcha.2023.101182 |
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author | Nichols, Gregory A. Qiao, Qing Déruaz-Luyet, Anouk Kraus, Bettina J. |
author_facet | Nichols, Gregory A. Qiao, Qing Déruaz-Luyet, Anouk Kraus, Bettina J. |
author_sort | Nichols, Gregory A. |
collection | PubMed |
description | BACKGROUND: Contemporary analyses of the distribution of heart failure (HF) patients by groups of ejection fraction are not available or are limited to hospitalized patients. Our objective was to quantify the per-person and system level clinical burden of a broad population of HF patients. METHODS: We studied 16,516 patients with a new HF diagnosis recorded in the electronic medical record of a U.S. integrated delivery system between 2005 and 2017. We used the diagnosis date as the index date and the nearest echocardiogram result to classify patients as HFrEF (n = 2,430), HFmrEF (n = 1,646), HFpEF (n = 12,440) and followed them through 2019 for major clinical outcomes (all-cause mortality, HF hospitalizations [HHF], all-cause hospitalizations, incident chronic kidney disease [CKD], progression of eGFR category, progression of CKD, incident type 2 diabetes [T2D], and progression to insulin use). We compared age and sex adjusted incidence rates and rate ratios of the outcomes between the HF types. RESULTS: Incidence rates for most outcomes were significantly higher among patients with HFrEF compared with HFpEF. HHF was 59 % greater, mortality 31 % greater, and CKD incidence 55 % greater, (p < 0.001 for all comparisons). However, the larger size of the HFpEF group generated 4.7–6.7 times as many total outcomes. CONCLUSIONS: Regardless of subtype, the presence of HF was associated with poor clinical outcomes. Incidence rates were higher for HFrEF than HFpEF, but as the latter represented 75% of the study population, HFpEF caused a greater overall burden on the health care system, reflecting the high unmet need of target therapies for HFpEF. |
format | Online Article Text |
id | pubmed-10424074 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-104240742023-08-15 The clinical burden of newly diagnosed Heart failure among patients with Reduced, mildly Reduced, and preserved ejection fraction Nichols, Gregory A. Qiao, Qing Déruaz-Luyet, Anouk Kraus, Bettina J. Int J Cardiol Heart Vasc Original Paper BACKGROUND: Contemporary analyses of the distribution of heart failure (HF) patients by groups of ejection fraction are not available or are limited to hospitalized patients. Our objective was to quantify the per-person and system level clinical burden of a broad population of HF patients. METHODS: We studied 16,516 patients with a new HF diagnosis recorded in the electronic medical record of a U.S. integrated delivery system between 2005 and 2017. We used the diagnosis date as the index date and the nearest echocardiogram result to classify patients as HFrEF (n = 2,430), HFmrEF (n = 1,646), HFpEF (n = 12,440) and followed them through 2019 for major clinical outcomes (all-cause mortality, HF hospitalizations [HHF], all-cause hospitalizations, incident chronic kidney disease [CKD], progression of eGFR category, progression of CKD, incident type 2 diabetes [T2D], and progression to insulin use). We compared age and sex adjusted incidence rates and rate ratios of the outcomes between the HF types. RESULTS: Incidence rates for most outcomes were significantly higher among patients with HFrEF compared with HFpEF. HHF was 59 % greater, mortality 31 % greater, and CKD incidence 55 % greater, (p < 0.001 for all comparisons). However, the larger size of the HFpEF group generated 4.7–6.7 times as many total outcomes. CONCLUSIONS: Regardless of subtype, the presence of HF was associated with poor clinical outcomes. Incidence rates were higher for HFrEF than HFpEF, but as the latter represented 75% of the study population, HFpEF caused a greater overall burden on the health care system, reflecting the high unmet need of target therapies for HFpEF. Elsevier 2023-02-14 /pmc/articles/PMC10424074/ /pubmed/37583714 http://dx.doi.org/10.1016/j.ijcha.2023.101182 Text en © 2023 The Authors. Published by Elsevier B.V. https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Original Paper Nichols, Gregory A. Qiao, Qing Déruaz-Luyet, Anouk Kraus, Bettina J. The clinical burden of newly diagnosed Heart failure among patients with Reduced, mildly Reduced, and preserved ejection fraction |
title | The clinical burden of newly diagnosed Heart failure among patients with Reduced, mildly Reduced, and preserved ejection fraction |
title_full | The clinical burden of newly diagnosed Heart failure among patients with Reduced, mildly Reduced, and preserved ejection fraction |
title_fullStr | The clinical burden of newly diagnosed Heart failure among patients with Reduced, mildly Reduced, and preserved ejection fraction |
title_full_unstemmed | The clinical burden of newly diagnosed Heart failure among patients with Reduced, mildly Reduced, and preserved ejection fraction |
title_short | The clinical burden of newly diagnosed Heart failure among patients with Reduced, mildly Reduced, and preserved ejection fraction |
title_sort | clinical burden of newly diagnosed heart failure among patients with reduced, mildly reduced, and preserved ejection fraction |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10424074/ https://www.ncbi.nlm.nih.gov/pubmed/37583714 http://dx.doi.org/10.1016/j.ijcha.2023.101182 |
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