Gouveia_et_al-2019-ESC_Heart_Failure.pdf

ESC Heart Failure

Aims Heart failure (HF) is a clinical syndrome with significant social and economic burden. We aimed to estimate the burden of HF in mainland Portugal over a 22-year time horizon, between 2014 and 2036. Methods and results Heart failure burden was measured in disability-adjusted life years (DALYs), resulting from the sum of years of life lost (YLL) due to premature death and years lost due to disability (YLD). YLL were estimated based on the Portuguese mortality rates reported by the European Detailed Mortality Database. For YLD, disease duration and the overall incidence were estimated using an epidemiological model developed by the World Health Organization (DISMOD II). Disability weights were retrieved from published literature. The impact of ageing was estimated with a shift-share analysis using official demographic projections. In 2014, 4688 deaths were attributed to HF, corresponding to 4.7% of the total deaths in mainland Portugal. DALYs totalled 21 162, 53.9% due to premature death (YLL: 11 398) and 46.1% due to disability (YLD: 9765). Considering only population ageing over a 22-year horizon, the deaths and burden of HF are expected to increase by 73.0% and 27.9%, respectively, reaching 8112 deaths and 27 059 DALYs lost due to HF in 2036. DALY's growth is mainly driven by the increase of YLL, whose contribution to overall burden will increase to 62.0%. Conclusions Heart failure is an emerging and growing health problem where significant health gains may be obtained. The projected significant increase of HF burden highlights the need to set HF as a priority for healthcare system.

European Journal of Heart Failure, 2013

This editorial refers to 'The epidemiology of heart failure, based on data for 2.1 million inhabitants in Sweden', by R. Zarrinkoub et al., published in this issue on pages 995 -1002.

European Journal of Internal Medicine, 2019

Background: To examine trends in the incidence, characteristics, and in-hospital outcomes of heart failure (HF) hospitalizations from 2001 to 2015 in Spain. Methods: Using the Spanish National Hospital Discharge Database (SNHDD) we selected admissions with a primary or secondary diagnosis of HF. The primary end points were trends in the incidence of hospitalizations and in-hospital mortality (IHM). Trends with primary and secondary diagnosis of HF were evaluated separately. Results: The incidence of HF coding increased significantly from 466.16 cases per 100,000 inhabitants in 2001-03 to 780.4 in 2013-15 (p < .001). Age increased over time (76.33 ± 10.92 years in 2001-03 vs. 79.4 ± 10.78 years in 2013-15; p < .001). We found a decrease in the percentage of women over the study period (53.07% vs. 52%; p < .001). We detected a significant increase in comorbidity according to the Charlson Comorbidity Index over time (mean 2.17 ± 0.98 in 2001-03 vs. 2.46 ± 1.04 in 2013-15). The most common associated comorbidities were atrial fibrillation (42.23%), hypertension (38.87%) and type 2 diabetes (34.3%). For the total time period, IHM was 12.79%. IHM decreased significantly over time from 13.47% in 2001-03 to 12.30% in 2013-15. Patients with HF coded as a secondary diagnosis have 66% higher risk of dying in the hospital that those with HF coded as a primary diagnosis. Conclusions: This research shows an increase of hospitalizations due to HF in Spain, particularly in patients with HF as a secondary diagnosis. Advance age and comorbidity in acute HF has increased in the recent years. However, IHM is decreasing while readmissions remain stable.

Medicina clínica práctica, 2020

To analyze the epidemiological characteristics of heart failure (HF) and estimate the burden of the disease on the health service by means of real world data (RWD). Patients and methods: All patients discharged from any Basque Health Service hospital after a first admission for HF between 2011 and 2015. Data sources: Databases of our health service. Outcomes: 30-and 365-day admissions, potentially avoidable hospitalizations (PAHs), mortality. Statistical analysis: Descriptive statistics, age-standardized event rates. Results: The cohort was composed of 15,109 patients (mean age 79.8 ± 10.1 years). At discharge patients had a median of 8 chronic conditions. 36% of them had had hospitalizations and 83% had visited a specialist (42% of them a cardiologist) during the previous year. Mortality was 24.5% within 365 days after discharge. Within 30 days after discharge, there were 2608 unplanned admissions, 49% for non-cardiovascular disease (CVD), 36% for HF and 15% for a CVD other than HF. 34% were classified as PAH. In the first 365 days after discharge, there were 14,559 hospitalizations, 54% for non-CVD reasons, 32% for HF and 13% for a CVD other than HF. Overall, 35% were PAHs. Conclusion: (1) People admitted for HF are old, and they have multimorbidity and high rates of admissions due to non-CVD reasons and PAHs after discharge. These finding suggest the need of strengthening continuity of care and managing comorbidities. (2) Besides, most people admitted for HF have previous contacts with the Healthcare system, which suggests opportunities for prevention before disease worsening.

European Heart Journal, 2018

Chronic heart failure-Epidemiology, prognosis, outcome 171 all). These observations were age-dependent (p<0.001 for all). At 1 year, fewer outpatient women were hospitalized and/or dead while these proportions were similar in patients after hospital discharge. Re-hospitalization probability in hospitalized cohort was stratified per gender and LVEF, and was highest in hospitalized patients (Figure). In multivariate analysis, age but not female gender was associated with higher hazard of death. Similar was observed for treatment with key HF medications but females had lower likelihood to have implanted an ICD. Figure 1. Rehospitalization probability. Conclusions: HF phenotype is gender dependent, as is the HF management. This however did not translate into worse prognosis. With ageing, HF management is less optimal and the outcome is worse. P899 Clinical, electrocardiographic, echocardiographic and cardiac magnetic resonance imaging follow-up in patients with non-compaction cardiomyopathy in isolation or in association with other diseases

Revista Portuguesa de Cardiologia (English Edition), 2020

Introduction and Objectives: Heart failure (HF) is a growing public health problem. This study estimates the current and future costs of HF in mainland Portugal. Methods: Costs were estimated based on prevalence and from a societal perspective. The annual costs of HF included direct costs (resource consumption) and indirect costs (productivity losses). Estimates were mostly based on data from the Diagnosis-Related Groups database, real-world data from primary care, and the opinions of an expert panel. Costs were estimated for 2014 and, taking population aging into account, changes were forecast up to 2036. Results: Direct costs in 2014 were C-299 million (39% for hospitalizations, 24% for medicines, 17% for exams and tests, 16% for consultations, and the rest for other needs, including emergencies and long-term care). Indirect costs were C-106 million (16% for absenteeism and 84% for reduced employment). Between 2014 and 2036, due to demographic dynamics, total costs will increase from C-405 to C-503 million. Per capita costs are estimated to rise by 34%, which is higher than the increase in total costs (+24%), due to the expected reduction in the resident population.

International Journal of Cardiology, 2017

Background: This study was undertaken to evaluate trends in heat failure hospitalizations (HFHs) and 1-year mortality of HFH in Lombardy, the largest Italian region, from 2000 to 2012. Methods: Hospital discharge forms with HF-related ICD-9 CM codes collected from 2000 to 2012 by the regional healthcare service (n = 699797 in 370538 adult patients), were analyzed with respect to in-hospital and 1-year mortality; Group (G) 1 included most acute HF episodes with primary cardiac diagnosis (70%); G2 included cardiomyopathies without acute HF codes (17%); and G3 included non-cardiac conditions with HF as secondary diagnosis (13%). Patients experiencing their first HFH since 2005 were analyzed as incident cases (n = 216782). Results: Annual HFHs number (mean 53830) and in-hospital mortality (9.4%) did not change over the years, the latter being associated with increasing age (p b 0.0001) and diagnosis Group (G1 9.1%, G2 5.6%, G3 15.9%, p b 0.0001). Incidence of new cases decreased over the years (3.62 [CI 3.58-3.67] in 2005 to 3.13 [CI 3.09-3.17] in 2012, per 1000 adult inhabitants/year, p b 0.0001), with an increasing proportion of patients aged ≥ 85 y (22.3% to 31.4%, p b 0.0001). Mortality lowered over time in b 75 y incident cases, both in-hospital (5.15% to 4.36%, p b 0.0001) and at 1-year (14.8% to 12.9%, p = 0.0006). Conclusions: The overall burden and mortality of HFH appear stable for more than a decade. However, from 2005 to 2012, there was a reduction of new, incident cases, with increasing age at first hospitalization. Meanwhile, both in-hospital and 1-year mortality decreased in patients aged b 75 y, possibly due to improved prevention and treatment.

2013

H eart failure (HF) is an important healthcare issue because of its high prevalence, mortality, morbidity, and cost of care. As of 2012, 2.4% of the US population has HF, with prevalence increasing with age such that among those ≥80 years of age, almost 12% of both men and women have HF. 1 Mortality is high, with 50% of Medicare beneficiaries not surviving 3 years after an HF hospitalization. 2 Although hospitalizations for HF have decreased slightly in recent years, 3 the cost of HF care is high and will remain a significant concern for the US healthcare system. If one assumes a continuation of present care practices, an increase in costs is expected, in part because patients with HF will survive longer because of the development and implementation of life-prolonging therapies, as well as aging of the population, which will lead to more patients at risk for developing HF.

Esc Heart Failure, 2022

Heart failure (HF) is a long-term clinical syndrome, with increasing prevalence and considerable healthcare costs that are further expected to increase dramatically. Despite significant advances in therapy and prevention, mortality and morbidity remain high and quality of life poor. Epidemiological data, that is, prevalence, incidence, mortality, and morbidity, show geographical variations across the European countries, depending on differences in aetiology, clinical characteristics, and treatment. However, data on the prevalence of the disease are scarce, as are those on quality of life. For these reasons, the ESC-HFA has developed a position paper to comprehensively assess our understanding of the burden of HF in Europe, in order to guide future policies for this syndrome. This manuscript will discuss the available epidemiological data on HF prevalence, outcomes, and human costs-in terms of quality of life-in European countries.

Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology, 2018

Heart failure is a major public health problem that affects a large number of individuals and is associated with high mortality and morbidity. This study aims to estimate the probable scenario for HF prevalence and its consequences in the short-, medium- and long-term in Portugal. This assessment is based on the EPICA (Epidemiology of Heart Failure and Learning) project, which was designed to estimate the prevalence of chronic heart failure in mainland Portugal in 1998. Estimates of heart failure prevalence were performed for individuals aged over 25 years, distributed by age group and gender, based on data from the 2011 Census by Statistics Portugal. The expected demographic changes, particularly the marked aging of the population, mean that a large number of Portuguese will likely be affected by this syndrome. Assuming that current clinical practices are maintained, the prevalence of heart failure in mainland Portugal will increase by 30% by 2035 and by 33% by 2060, compared to 20...