Impact of Clinical Characteristics and Management on the Prognosis of Unselected Heart Failure Patients

Purpose Heart failure (HF) is a major public health issue. This study conducted a real-life analysis of the impact of clinical characteristics and medical management of HF on its prognosis. Methods Analysis was based on the EGB (“Echantillon Généraliste des Bénéficiaires”) database. A cohort compris...

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Bibliographic Details
Published in:Cardiovascular drugs and therapy 2015-02, Vol.29 (1), p.89-98
Main Authors: Eschalier, Romain, Chenaf, Chouki, Mulliez, Aurélien, Yalioua, Arab, Clerfond, Guillaume, Authier, Nicolas, Vorilhon, Charles, Citron, Bernard, Pereira, Bruno, Jean, Frédéric, Souteyrand, Géraud, Motreff, Pascal, Eschalier, Alain, Lusson, Jean-René
Format: Article
Language:English
Subjects:
Adrenergic beta-Antagonists - therapeutic use
Aged
Aged, 80 and over
Angiotensin II Type 1 Receptor Blockers - therapeutic use
Angiotensin-Converting Enzyme Inhibitors - therapeutic use
Cardiology
Cohort Studies
Female
France - epidemiology
Heart Failure - drug therapy
Heart Failure - epidemiology
Hospitalization - statistics & numerical data
Humans
Kaplan-Meier Estimate
Male
Medicine
Medicine & Public Health
Middle Aged
Mineralocorticoid Receptor Antagonists - therapeutic use
Original Article
Prognosis
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Summary:Purpose Heart failure (HF) is a major public health issue. This study conducted a real-life analysis of the impact of clinical characteristics and medical management of HF on its prognosis. Methods Analysis was based on the EGB (“Echantillon Généraliste des Bénéficiaires”) database. A cohort comprising 1825 adult patients with a first admission for HF between 2009 and 2011 was created and followed until June 2013 (median 22.3 [7.7–34.5] months) for survival analysis. Results Mean age was 77.3 ± 13.2 years (53 % ≥80 years). The overall incidence of HF admission was 117 [112–122] per 100,000 population with a marked increase in patients >80 years (1297 [1217–1348]). At discharge, only 8 % of patients received recommended combination of angiotensin converting enzyme inhibitors/angiotensin receptor blockers (ACEi/ARB), beta-blockers (BB) and mineralocorticoid receptor antagonists (MRA). Only prescription levels of BB and vitamin K antagonists, at discharge, increased during the study period. In-hospital mortality was 9 % and survival was 71.6 %[69.5–73.6] and 52.0 %[49.4–54.6] at 12 and 36 months, respectively. In multivariate analysis, female gender [HR:0.78 (0.67–0.91), p  = 0.001], ACEi/ARB + BB + MRA [0.41 (0.28–0.60), p  
ISSN:0920-3206
1573-7241
DOI:10.1007/s10557-015-6572-y