HF 5-Year Survival Is Poor, Regardless of Ejection Fraction

Patients with heart failure (HF) with preserved (HFpEF), borderline (HFbEF), or reduced (HFrEF) ejection fraction (EF) have similarly poor rates of 5-year survival, as well as a higher risk for cardiovascular and HF hospital admission, according to a recent study.

Findings from the study were presented at the American Heart Association (AHA) Scientific Sessions 2017, which is taking place from November 11 to 15, 2017.

For their study, the researchers assessed 39,982 patients from 254 hospitals who had been admitted for HF between 2005 and 2009. Of these, 18,299 (16%) had HFpEF, 3285 (8.2%) had HFbEF, and 18,398 (46%) had HRrEF.

Data from Get With The Guidelines-Heart Failure (GWTG-HF) and Medicare were obtained and linked for longitudinal follow-up. Five-year outcomes were investigated via multivariable models, and median survival was compared with that of the US population.

Results showed that overall median survival in all groups was 2 years, and risk-adjusted survival indicated that 5-year mortality was similar across groups. Ultimately, the researchers found that mortality occurred within 5 years in 75.3% in patients with HFrEF, compared with 75.7% in patients with HFpEF and 75.7% in patients with HFbEF.

Risk-adjusted analyses showed that the composite of mortality and readmission to the hospital were similar across all subgroups. However, the rates of cardiovascular and HF readmission were higher in patients with HFrEF and HFbEF vs those with HFpEF.

“Among patients hospitalized with HF, patients across the EF spectrum have a similarly poor 5-year survival with an elevated risk for cardiovascular and HF admission,” the researchers concluded. “These findings underscore the need to improve treatment of patients with HF.”

—Christina Vogt

Reference:

Shah KS, Xu H, Matsouaka RA, et al. Heart failure with preserved, borderline, and reduced ejection fraction: 5-year outcomes [Published online November 12, 2017]. J Am Coll Cardiol. doi:10.1016/j.jacc.2017.08.074.