European Heart Journal - Quality of Care and Clinical Outcomes最新文献

{"title":"Economic evaluation of the Liverpool heart failure virtual ward model.","authors":"Debar Rasoul, Ipsita Chattopadhyay, Tony Mayer, Jenni West, Hadleigh Stollar, Casey Black, Emeka Oguguo, Rosie Kaur, Rachael MacDonald, Jessica Pocock, Barbara Uzdzinska, Bethany Umpleby, Nick Hex, Gregory Yoke Hong Lip, Rajiv Sankaranarayanan","doi":"10.1093/ehjqcco/qcae095","DOIUrl":"10.1093/ehjqcco/qcae095","url":null,"abstract":"<p><strong>Background: </strong>A virtual ward (VW) supports patients who would otherwise need hospitalization by providing acute care, remote monitoring, investigations, and treatment at home. By March 2024, the VW programme had treated 10 950 patients across six speciality VWs, including heart failure (HF). This evaluation presents the economic assessment of the Liverpool HF VW.</p><p><strong>Method and results: </strong>A comprehensive economic cost comparison model was developed by the York Health Economics Consortium (University of York) to compare the costs of the VW to standard hospital inpatient care [standard care (SC)]. The model included direct VW costs and additional costs across the care pathway. Costs and resource use for 648 patients admitted to the HF VW were calculated for 30 days post-discharge and total cohort costs were extrapolated to a full year. Primary outcomes included costs related to length of stay, readmissions, and NHS 111 contact. The total cost for the HF VW pathway, including set-up costs, was £467 524. This results in an incremental net cost benefit of £735 512 compared with the total SC cost of £1 203 036, indicating a substantial net cost benefit of £1135 per patient per episode (PPPE). This advantage remains despite initial setup expenses and ongoing costs such as home visits, virtual consultations, point-of-care testing, and home monitoring equipment.</p><p><strong>Conclusion: </strong>Our HF VW model offers a substantial net cost benefit, driven by reduced hospital stays, fewer emergency department visits, and lower readmission rates. The study highlights the importance of considering system-wide impacts and continuous monitoring of VWs as they develop.</p>","PeriodicalId":11869,"journal":{"name":"European Heart Journal - Quality of Care and Clinical Outcomes","volume":" ","pages":"197-205"},"PeriodicalIF":4.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National health expenditure per capita is associated with CRT implantation practice: findings from the ESC CRT Survey II with 11 088 patients.","authors":"Camilla Normand, Nigussie Bogale, Cecilia Linde, Stelios Tsintzos, Zenichi Ihara, Kenneth Dickstein","doi":"10.1093/ehjqcco/qcae082","DOIUrl":"10.1093/ehjqcco/qcae082","url":null,"abstract":"<p><strong>Aims: </strong>Cardiac resynchronization therapy (CRT) reduces morbidity and mortality in selected patients with heart failure (HF) and electrical dyssynchrony. This treatment receives class IA recommendations in European Society of Cardiology (ESC) guidelines. However, despite these strong recommendations, CRT implantation practice varies greatly in Europe. The purpose of the sub-analysis of CRT Survey II data was to describe how countries' health per capita expenditure affects CRT implantation practice.</p><p><strong>Methods and results: </strong>Between 2015 and 2016, two ESC associations, European Heart Rhythm Association and Heart Failure Association, conducted the CRT Survey II, a survey of CRT implantations in 11 088 patients in 42 ESC member states. We analysed CRT patient selection and guideline adherence in those countries according to high or low health expenditure per capita. There were 21 high health expenditure countries (n = 6844 patients) and 21 (n = 3852) with low health expenditure. The countries with the lowest health expenditure were more likely to implant CRT in patients who had strong guideline recommendations for implantation, younger patients and those recently hospitalized for HF or with symptomatic HF (67% vs. 58%, P < 0.001). The ratio of CRT-Pacemaker (CRT-P) to CRT-Defibrillator (CRT-D) was similar in both spending groups, as was the percentage of CRT implantation in women.</p><p><strong>Conclusion: </strong>CRT Survey II has demonstrated a non-uniform delivery of healthcare. Countries with low health expenditure per capita appear to be reserving CRT therapy for younger patients, those with class IA indication and patients with more severe symptoms of heart failure.</p>","PeriodicalId":11869,"journal":{"name":"European Heart Journal - Quality of Care and Clinical Outcomes","volume":" ","pages":"160-165"},"PeriodicalIF":4.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Profiling heart failure with preserved or mildly reduced ejection fraction by cluster analysis.","authors":"Lourdes Vicent, Nicolás Rosillo, Jorge Vélez, Guillermo Moreno, Pablo Pérez, José Luis Bernal, Germán Seara, Rafael Salguero-Bodes, Fernando Arribas, Héctor Bueno","doi":"10.1093/ehjqcco/qcae067","DOIUrl":"10.1093/ehjqcco/qcae067","url":null,"abstract":"<p><strong>Background: </strong>Significant knowledge gaps remain regarding the heterogeneity of heart failure (HF) phenotypes, particularly among patients with preserved or mildly reduced left ventricular ejection fraction (HFp/mrEF). Our aim was to identify HF subtypes within the HFp/mrEF population.</p><p><strong>Methods: </strong>K-prototypes clustering algorithm was used to identify different HF phenotypes in a cohort of 2570 patients diagnosed with heart failure with mildly reduced ejection fraction or heart failure with preserved left ventricular ejection fraction. This algorithm employs the k-means algorithm for quantitative variables and k-modes for qualitative variables.</p><p><strong>Results: </strong>We identified three distinct phenotypic clusters: Cluster A (n = 850, 33.1%), characterized by a predominance of women with low comorbidity burden; Cluster B (n = 830, 32.3%), mainly women with diabetes mellitus and high comorbidity; and Cluster C (n = 890, 34.5%), primarily men with a history of active smoking and respiratory comorbidities. Significant differences were observed in baseline characteristics and 1-year mortality rates across the clusters: 18% for Cluster A, 33% for Cluster B, and 26.4% for Cluster C (P < 0.001). Cluster B had the shortest median time to death (90 days), followed by Clusters C (99 days) and A (144 days) (P < 0.001). Stratified Cox regression analysis identified age, cancer, respiratory failure, and laboratory parameters as predictors of mortality.</p><p><strong>Conclusion: </strong>Cluster analysis identified three distinct phenotypes within the HFp/mrEF population, highlighting significant heterogeneity in clinical profiles and prognostic implications. Women were classified into two distinct phenotypes: low-risk women and diabetic women with high mortality rates, while men had a more uniform profile with a higher prevalence of respiratory disease.</p>","PeriodicalId":11869,"journal":{"name":"European Heart Journal - Quality of Care and Clinical Outcomes","volume":" ","pages":"140-148"},"PeriodicalIF":4.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicoeconomic burden among heart failure patients with severely reduced ejection fraction after hospital admission: HF-RESTORE.","authors":"Heidi T May, Jeffrey L Anderson, Michael Butzner, Punag H Divanji, Joseph B Muhlestein","doi":"10.1093/ehjqcco/qcae081","DOIUrl":"10.1093/ehjqcco/qcae081","url":null,"abstract":"<p><strong>Background: </strong>An estimated two-thirds of heart failure (HF) patients with reduced ejection fraction (HFrEF) hospitalized in the United States have a severely reduced left ventricular ejection fraction (LVEF <30%). Few studies have categorized patients according to their severity of left ventricular dysfunction beyond an LVEF of <30%.</p><p><strong>Methods and results: </strong>Intermountain Health patients (≥18 years) with a primary HF diagnosis, more than or equal to 1 inpatient hospitalization with a primary discharge diagnosis of HF, a documented LVEF of <30%, and a B-type natriuretic peptide >100 pg/mL within 1 year of hospitalization were studied. Patients were stratified by LVEF levels (≤15%, 16-25%, and 26-29%) and evaluated for death, HF hospitalization, healthcare resource utilization, and medical costs. Overall, 2184 patients (mean age 64.2 ± 15.5 years, 72.5% male) were stratified by LVEF [≤15%, n = 468 (21.4%); 16-25%, n = 1399 (64.1%); and 26-29%, n = 317 (14.5%)]. Lower LVEF was associated with younger age, male sex, and fewer comorbidities. Although 1-year mortality differed significantly between LVEF stratifications, which remained after adjustment by risk factors [vs. LVEF 26-29% (referent): ≤15%, hazard ratio (HR) = 1.92, P < 0.0001; and 16-25%, HR = 1.42, P = 0.01], mortality was similar by 3 years. HF hospitalizations at 1 and 3 years were similar among LVEF groups. Total HF costs-driven by increased HF outpatient costs-were significantly higher among LVEF of ≤15%.</p><p><strong>Conclusion: </strong>Patients with an LVEF of ≤15% had a modestly increased risk of 1-year mortality, as well as significantly higher total HF costs. Patients with HFrEF and a severely reduced LVEF continue to face an increased clinicoeconomic burden, and novel therapies to treat this unmet medical need are warranted.</p>","PeriodicalId":11869,"journal":{"name":"European Heart Journal - Quality of Care and Clinical Outcomes","volume":" ","pages":"149-159"},"PeriodicalIF":4.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Loss of quality of life and increased societal costs in patients with hypertrophic cardiomyopathy: the AFFECT-HCM study.","authors":"Stephan A C Schoonvelde, Isabell Wiethoff, Peter-Paul Zwetsloot, Alexander Hirsch, Christian Knackstedt, Tjeerd Germans, Maurits Sikking, Arend F L Schinkel, Marjon A van Slegtenhorst, Judith M A Verhagen, Rudolf A de Boer, Silvia M A A Evers, Mickaël Hiligsmann, Michelle Michels","doi":"10.1093/ehjqcco/qcae092","DOIUrl":"10.1093/ehjqcco/qcae092","url":null,"abstract":"<p><strong>Introduction: </strong>Hypertrophic cardiomyopathy (HCM) is the most prevalent inherited cardiac disease. The impact of HCM on quality of life (QoL) and societal costs remains poorly understood. This prospective multi-centre burden of disease study estimated QoL and societal costs of genotyped HCM patients and genotype-positive phenotype-negative (G+/P-) subjects.</p><p><strong>Methods and results: </strong>Participants were categorized into three groups based on genotype and phenotype: (i) G+/P- [left ventricular (LV) wall thickness <13 mm], (ii) non-obstructive HCM [nHCM, LV outflow tract (LVOT) gradient <30 mmHg], and (iii) obstructive HCM (oHCM, LVOT gradient ≥30 mmHg). We assessed QoL with EQ-5D-5L and Kansas City Cardiomyopathy Questionnaires (KCCQ). Societal costs were measured using medical consumption (Medical Consumption Questionnaire) and productivity cost (iMTA Productivity Cost Questionnaire) questionnaires. We performed subanalyses within three age groups: <40, 40-59, and ≥60 years. From three Dutch hospitals, 506 subjects were enrolled (84 G+/P-, 313 nHCM, 109 oHCM; median age 59 years, 39% female). HCM (both nHCM and oHCM) patients reported reduced QoL vs. G+/P- subjects (KCCQ: 88 vs. 98, EQ-5D-5L: 0.88 vs. 0.96; both P < 0.001). oHCM patients reported lower KCCQ scores than nHCM patients (83 vs. 89, P = 0.036). Societal costs were significantly higher in HCM patients (€19,035/year vs. €7385/year) compared with G+/P- controls, mainly explained by higher healthcare costs and productivity losses. Being symptomatic and of younger age (<60 years) particularly led to decreased QoL and increased costs.</p><p><strong>Conclusion: </strong>HCM is associated with decreased QoL and increased societal costs, especially in younger and symptomatic patients. oHCM patients were more frequently symptomatic than nHCM patients. This study highlights the substantial disease burden of HCM and can aid in assessing new therapy cost-effectiveness for HCM in the future.</p>","PeriodicalId":11869,"journal":{"name":"European Heart Journal - Quality of Care and Clinical Outcomes","volume":" ","pages":"174-185"},"PeriodicalIF":4.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional disparities in heart transplant mortality in the USA.","authors":"Cesar Rodrigo Zoni, Matthew Dean, Laurel A Copeland, Chittoor B Sai Sudhakar, Yazhini Ravi","doi":"10.1093/ehjqcco/qcae083","DOIUrl":"10.1093/ehjqcco/qcae083","url":null,"abstract":"<p><strong>Background: </strong>Mortality after heart transplantation can be influenced by multiple factors. This study analysed its variation across four regions of the USA.</p><p><strong>Objective: </strong>Analyse the differences in mortality among patients receiving a heart transplant across four regions of the USA.</p><p><strong>Methods and results: </strong>Organ Procurement and Transplantation Network/United Network for Organ Sharing registry was analysed for adult heart transplant recipients from 1987 to 2023. They were divided into four regions according to heart transplant recipients' residence: the Northeast, Midwest, South, and West. The endpoint was all-cause mortality. A total of 33 482 heart transplant recipients were included in the analysis. Baseline characteristics differed by region. The median survival (years) was lower in the South [Northeast 12.9 (6.1-17.9), Midwest 13.1 (6.5-18.1), South 11.6 (5.3-16.8), and West 13.6 (7.0-18.6); P < 0.0001]. Mortality incidence rate was greater in the South. When compared to the Northeast, in the unadjusted analysis, mortality was higher in the South {hazard ratio (HR) 1.13 [95% confidence interval (CI) 1.07-1.19], P < 0.001} and lower in the West [HR 0.89 (95% CI 0.83-0.94), P < 0.001]. After adjusting for demographic and clinical variables, only the South retained significant differences [HR 1.17 (95% CI 1.10-1.24), P < 0.001]. Mortality significantly increased in all regions after 2018.</p><p><strong>Conclusion: </strong>Mortality of heart transplant recipients varies across region of residence in the USA. A significant increase in adjusted mortality was observed in the South. These findings suggest that there are regional disparities in the mortality rates of heart transplant recipients.</p>","PeriodicalId":11869,"journal":{"name":"European Heart Journal - Quality of Care and Clinical Outcomes","volume":" ","pages":"166-173"},"PeriodicalIF":4.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An early accumulation of serum uric acid confers more risk of heart failure: a 10-year prospective cohort study.","authors":"Xue Tian, Shuohua Chen, Yijun Zhang, Xue Xia, Qin Xu, Shouling Wu, Anxin Wang","doi":"10.1093/ehjqcco/qcae054","DOIUrl":"10.1093/ehjqcco/qcae054","url":null,"abstract":"<p><strong>Background: </strong>Evidence on the longitudinal association of serum uric acid (SUA) with the risk of heart failure (HF) was limited and controversial. This study aimed to investigate the associations of cumulative SUA (cumSUA), incorporating its time course of accumulation, with the risk of HF.</p><p><strong>Methods and results: </strong>This prospective study enrolled 54 606 participants from the Kailuan study. The magnitude of SUA accumulation was expressed as cumSUA, exposure duration, and cumulative burden from baseline to the third survey, with cumSUA, calculated by multiplying mean values between consecutive examinations by time intervals between visits, as the primary exposure.During a median follow-up of 10 years, 1260 cases of incident HF occurred. A higher risk of HF was observed in participants with the highest vs. the lowest quartile of cumSUA [adjusted hazard ratio (aHR), 1.54; 95% confidence interval (CI), 1.29-1.84], 6-year vs. 0-year exposure duration (aHR, 1.87; 95% CI, 1.43-2.45), cumulative burden >0 vs. = 0 (aHR, 1.55; 95 CI, 1.29-1.86), and those with a negative vs. positive SUA slope (aHR, 1.12; 95% CI, 1.02-1.25). When cumSUA was incorporated with its time course, those with cumSUA ≥median and a negative SUA slope had the highest risk of HF (aHR, 1.55; 95% CI, 1.29-1.86).</p><p><strong>Conclusions: </strong>Incident HF risk was associated with the magnitude and time course of cumSUA accumulation. Early accumulation resulted in a greater risk of HF compared with later accumulation, indicating the importance of optimal SUA control earlier in life.</p>","PeriodicalId":11869,"journal":{"name":"European Heart Journal - Quality of Care and Clinical Outcomes","volume":" ","pages":"113-122"},"PeriodicalIF":4.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141450156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency of misdiagnosis in hypertrophic cardiomyopathy.","authors":"Søren K Nielsen, Torsten B Rasmussen, Thomas M Hey, Tomas Zaremba, Jens F Lassen, Jens Mogensen","doi":"10.1093/ehjqcco/qcae031","DOIUrl":"10.1093/ehjqcco/qcae031","url":null,"abstract":"<p><strong>Background and aims: </strong>Hypertrophic cardiomyopathy (HCM) is characterized by unexplained left ventricular hypertrophy (LVH) ≥15 mm. The condition is often hereditary, and family screening is recommended to reduce the risk of adverse disease complications and premature death among relatives. Correct diagnosis of index patients is important to ensure that only relatives at risk of disease development are invited for family screening. To investigate whether patients with International Classification of Disease, Tenth Revision (ICD-10) codes for HCM (DI421) or hypertrophic obstructive cardiomyopathy (HOCM) (DI422) fulfilled recognized diagnostic criteria.</p><p><strong>Methods: </strong>All patients with ICD-10 codes for HCM or HOCM at a Department of Cardiology were identified and had their diagnosis validated by a cardiac investigation or a review of their medical records and previous investigations.</p><p><strong>Results: </strong>A total of 240 patients had ICD-10 codes for HCM/HOCM, of whom 202 (84%, 202/240) underwent re-examination, while 38 (16%, 38/240) had their hospital notes reviewed. A total of 76 patients (32%, n = 76/240) did not fulfil diagnostic criteria, of whom 39 (51%, n = 39/76) had normal (10 mm) or modest LV wall thickness (11-14 mm). The remaining 37 patients (49%, n = 37/76) had LVH ≥15 mm, which was well explained by uncontrolled hypertension (32%, n = 24/76), aortic valve stenosis (19%, n = 7/76), or wild-type amyloidosis (16%, n = 6/76).</p><p><strong>Conclusion: </strong>One-third of patients with ICD-10 codes for HCM or HOCM did not fulfil recognized diagnostic criteria. Incorrect diagnosis of HCM may cause unnecessary family investigations, which may be associated with anxiety, and a waste of healthcare resources. This highlights the need for specialized cardiomyopathy services to ensure correct diagnosis and management of HCM.</p>","PeriodicalId":11869,"journal":{"name":"European Heart Journal - Quality of Care and Clinical Outcomes","volume":" ","pages":"105-112"},"PeriodicalIF":4.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140854651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of weight loss in hospitalized patients with heart failure.","authors":"Takanori Nagahiro, Masaaki Konishi, Nobuyuki Kagiyama, Takatoshi Kasai, Kentaro Kamiya, Hiroshi Saito, Kazuya Saito, Emi Maekawa, Takeshi Kitai, Kentaro Iwata, Kentaro Jujo, Hiroshi Wada, Shin-Ichi Momomura, Kiyoshi Hibi, Kouichi Tamura, Yuya Matsue","doi":"10.1093/ehjqcco/qcae058","DOIUrl":"10.1093/ehjqcco/qcae058","url":null,"abstract":"<p><strong>Background: </strong>Weight loss is a poor prognostic factor in patients with chronic heart failure (HF). However, whether the same is true for hospitalized patients with HF is unknown, even though hospitalization is the first opportunity for many patients to be diagnosed with HF. This study aimed to investigate the prognostic value of weight loss in patients hospitalized for HF.</p><p><strong>Methods and results: </strong>This was a post-hoc analysis of the FRAGILE-HF study, a prospective multi-center, observational study including 1332 hospitalized older (≥65 years) patients with HF. The primary outcome was all-cause death within two years of discharge. Self-reported body weight data 1 year prior to hospital admission were available for 1106 patients (83.0%) and were compared with their weight after decongestion therapy. The median weight change was -6.9% [-2.4 - -11.9] and 86.8% of the overall cohort experienced some weight loss. Whereas patients with weight loss ≥5%, which is a well-validated cut-off in chronic HF, had comparable mortality to those with less weight loss (P = 0.96 by log-rank test), patients with weight loss >12%, the lowest quartile value, had higher mortality than those with less weight loss (P = 0.024 for all-cause mortality, P = 0.028 for non-cardiovascular mortality, and P = 0.28 for cardiovascular mortality, respectively). In a Cox proportional hazard model, >12% weight loss was associated with high mortality after adjusting for known prognostic factors and history of malignancy (adjusted hazard ratio: 1.485 [1.070-2.062], P = 0.018).</p><p><strong>Conclusion: </strong>Weight loss derived from patient-reported body weight 1 year before hospitalization was significantly associated with increased mortality after discharge, mainly due to non-cardiovascular etiology, in elderly patients hospitalized for HF.</p>","PeriodicalId":11869,"journal":{"name":"European Heart Journal - Quality of Care and Clinical Outcomes","volume":" ","pages":"123-129"},"PeriodicalIF":4.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141727014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal trends in mortality, heart failure hospitalization, and stroke in heart failure patients with and without atrial fibrillation: a nationwide study from 1997 to 2018 on 152 059 patients.","authors":"Marte Austreim, Nina Nouhravesh, Mariam E Malik, Noor Abassi, Deewa Zahir, Caroline Hartwell Garred, Camilla F Andersen, Morten Lock Hansen, Jonas Bjerring Olesen, Emil Fosbøl, Lauge Østergaard, Lars Køber, Morten Schou","doi":"10.1093/ehjqcco/qcae061","DOIUrl":"10.1093/ehjqcco/qcae061","url":null,"abstract":"<p><strong>Aims: </strong>We aimed to investigate temporal trends in all-cause mortality, heart failure (HF) hospitalization, and stroke from 1997 to 2018 in patients diagnosed with both HF and atrial fibrillation (AF).</p><p><strong>Methods and results: </strong>From Danish nationwide registers, we identified 152 059 patients with new-onset HF between 1997 and 2018. Patients were grouped according to year of new-onset HF and AF-status: Prevalent AF (n = 34 734), New-onset AF (n = 12 691), and No AF (n = 104 634). Median age decreased from 76 to 73 years between 1997 and 2018. The proportion of patients with prevalent or new-onset AF increased from 24.7% (n = 9256) to 35.8% (n = 14 970). Five-year risk of all-cause mortality went from 69.1% [confidence interval (CI): 67.9-70.2%] to 51.3% (CI: 49.9-52.7%), 62.3% (CI: 60.5-64.4%) to 43.0% (CI: 40.5-45.5%), and 61.9% (CI: 61.3-62.4%) to 36.7% (CI: 35.9-37.6%) for the Prevalent AF, New-onset AF, and No AF-group, respectively. Minimal changes were observed in the risk of HF-hospitalization. Five-year stroke risk decreased from 8.5% (CI: 7.8-9.1%) to 5.0% (CI: 4.4-5.5%) for the prevalent AF group, 8.2% (CI: 7.2-9.2%) to 4.6% (CI: 3.7-5.5%) for new-onset AF, and 6.3% (CI: 6.1-6.6%) to 4.9% (CI: 4.6-5.3%) for the No AF group. Simultaneously, anticoagulant therapy increased for patients with prevalent (from 42.7 to 93.1%) and new-onset AF (from 41.9 to 92.5%).</p><p><strong>Conclusion: </strong>From 1997 to 2018, we observed an increase in patients with HF and co-existing AF. Mortality decreased for all patients, regardless of AF-status. Anticoagulation therapy increased, and stroke risk for patients with AF was reduced to a similar level as patients without AF in 2013-2018.</p>","PeriodicalId":11869,"journal":{"name":"European Heart Journal - Quality of Care and Clinical Outcomes","volume":" ","pages":"130-139"},"PeriodicalIF":4.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141747818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}