Higher New York Heart Association classes and increased mortality and hospitalization in patients with heart failure and preserved left ventricular function. Export

@article{citeulike:511830, abstract = {BACKGROUND: The association between higher New York Heart Association (NYHA) class and outcomes in patients with heart failure and preserved systolic function is not well known. METHODS: We performed a retrospective follow-up study of 988 patients with heart failure with ejection fraction > 45\% who participated in the DIG trial. Using Cox proportional hazard models, we estimated risks and all-cause mortality, heart failure mortality, all-cause hospitalization, and hospitalization due to worsening heart failure during a median follow-up of 38.5 months. RESULTS: Patients had a median age of 68 years; 41.2\% were women and 13.9\%, nonwhites. Overall, 23.4\% of patients died, and 19.9\% were hospitalized because of worsening heart failure. Proportion of patients with NYHA classes I, II, III, and IV were 19.9\%, 58.0\%, 20.9\%, and 1.2\%, respectively, and 14.7\%, 21.1\%, 35.9\%, and 58.3\%, respectively, died of all causes (P < .001 for trend). Respective rates for heart failure-related hospitalizations were 14.2\%, 17.1\%, 32.5\%, and 33.3\% (P < .001 for trend). Compared with NYHA class I patients, adjusted hazard ratios (HRs) for all-cause mortality for class II, III, and IV patients were 1.54 (95\% CI 1.02-2.32, P = .042), 2.56 (95\% CI 1.64-24.01, P < .001), and 8.46 (95\% CI 3.57-20.03, P < .001), respectively. Respective adjusted HRs (95\% CI) for hospitalization due to heart failure for class II, III, and IV patients were 1.16 (0.76-1.77) (P = .502), 2.27 (1.45-3.56) (P < .001), and 3.71 (1.25-11.02) (P = 018). New York Heart Association classes II through IV were also associated with higher risk of all-cause hospitalization. CONCLUSION: Higher NYHA classes were associated with poorer outcomes in patients with heart failure and preserved systolic function.}, address = {Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Alabama, Birmingham, AL, USA. aahmed@uab.edu}, author = {Ahmed, A. and Aronow, W. S. and Fleg, J. L.}, citeulike-article-id = {511830}, citeulike-linkout-0 = {http://dx.doi.org/10.1016/j.ahj.2005.03.066}, citeulike-linkout-1 = {http://view.ncbi.nlm.nih.gov/pubmed/16442912}, citeulike-linkout-2 = {http://www.hubmed.org/display.cgi?uids=16442912}, doi = {10.1016/j.ahj.2005.03.066}, issn = {1097-6744}, journal = {Am Heart J}, keywords = {diastolic, hf, nyha, preserved}, month = {February}, number = {2}, pages = {444--450}, posted-at = {2006-02-19 18:46:14}, priority = {2}, title = {Higher New York Heart Association classes and increased mortality and hospitalization in patients with heart failure and preserved left ventricular function.}, url = {http://dx.doi.org/10.1016/j.ahj.2005.03.066}, volume = {151}, year = {2006} }

TY - JOUR ID - citeulike:511830 L3 - citeulike-article-id:511830 N2 - BACKGROUND: The association between higher New York Heart Association (NYHA) class and outcomes in patients with heart failure and preserved systolic function is not well known. METHODS: We performed a retrospective follow-up study of 988 patients with heart failure with ejection fraction > 45% who participated in the DIG trial. Using Cox proportional hazard models, we estimated risks and all-cause mortality, heart failure mortality, all-cause hospitalization, and hospitalization due to worsening heart failure during a median follow-up of 38.5 months. RESULTS: Patients had a median age of 68 years; 41.2% were women and 13.9%, nonwhites. Overall, 23.4% of patients died, and 19.9% were hospitalized because of worsening heart failure. Proportion of patients with NYHA classes I, II, III, and IV were 19.9%, 58.0%, 20.9%, and 1.2%, respectively, and 14.7%, 21.1%, 35.9%, and 58.3%, respectively, died of all causes (P < .001 for trend). Respective rates for heart failure-related hospitalizations were 14.2%, 17.1%, 32.5%, and 33.3% (P < .001 for trend). Compared with NYHA class I patients, adjusted hazard ratios (HRs) for all-cause mortality for class II, III, and IV patients were 1.54 (95% CI 1.02-2.32, P = .042), 2.56 (95% CI 1.64-24.01, P < .001), and 8.46 (95% CI 3.57-20.03, P < .001), respectively. Respective adjusted HRs (95% CI) for hospitalization due to heart failure for class II, III, and IV patients were 1.16 (0.76-1.77) (P = .502), 2.27 (1.45-3.56) (P < .001), and 3.71 (1.25-11.02) (P = 018). New York Heart Association classes II through IV were also associated with higher risk of all-cause hospitalization. CONCLUSION: Higher NYHA classes were associated with poorer outcomes in patients with heart failure and preserved systolic function. IS - 2 JF - Am Heart J SN - 1097-6744 AD - Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Alabama, Birmingham, AL, USA. aahmed@uab.edu EP - 450 TI - Higher New York Heart Association classes and increased mortality and hospitalization in patients with heart failure and preserved left ventricular function. VL - 151 SP - 444 KW - diastolic KW - hf KW - nyha KW - preserved AU - Ahmed, A AU - Aronow, WS AU - Fleg, JL PY - 2006/02// UR - http://dx.doi.org/10.1016/j.ahj.2005.03.066 ER -