- More people hospitalized for heart failure are surviving longer.
- Yet their prognosis remains poor, as only one in three patients hospitalized with acute decompensated heart failure (ADHF) in 2004 survived beyond five years.
- Researchers noted that heart failure patients are older and sicker compared to the previous decade.
But overall, long-term survival rates remain low, researchers said.
Unlike chronic heart failure, in which patients are able to live at home, acute decompensated heart failure involves a severe deterioration in health. Fluid backs up in the lungs, breathing becomes difficult and the heart is unable to supply the body’s necessary oxygen.
“Heart failure is a lethal disease with a worse life expectancy than many types of cancer,” said Samuel W. Joffe, M.D., lead author of the study and a cardiac fellow at the University of Massachusetts Memorial Medical Center, in Worcester. People hospitalized with heart failure are “very sick and their life expectancy is quite limited.”
Comparing 9,748 patients admitted to 11 central Massachusetts medical centers with acute decompensated heart failure in 1995 to those in 2004, researchers found good and bad news:
- The proportion of people who died while hospitalized in 2004 decreased 21 percent compared to 1995.
- The proportion who died within 30 days of discharge in 2004 decreased 18 percent compared to 1995.
- Long-term survival, 5 years or more, improved by 45% in 2004 compared to 1995.
- Patients admitted to hospitals in 2004 with acute decompensated heart failure were older and sicker than those admitted in 1995.
- Patients in 2004 were more likely to have other chronic illnesses such as anemia, high blood pressure and chronic kidney disease.
“While survival for patients in this study improved significantly, their prognosis was still poor, as only about one in three of these patients hospitalized with heart failure survived five years or more,” Joffe said.
Treatment guidelines for heart failure, released jointly in 1995 by the American Heart Association and American College of Cardiology, may have played a role in the short-term improvements, Joffe said.
Patients hospitalized in 2004 were more likely to be treated with aspirin, beta blockers and lipid-lowering agents or statins. They were less likely to be treated with calcium channel blockers and digoxin.
It’s not clear if changes in medications directly caused the increase in survival, Joffe said, noting that better pacemakers, defibrillators, overall medical care, or other factors also may have played a role.
Heart attack remains the leading cause of heart failure. Eating fresh fruits, vegetables, whole grains and lean protein sources, as well as exercising regularly, avoiding smoking and maintaining healthy cholesterol and blood pressure levels can help prevent heart attack and thus heart failure.
Co-authors are Robert Goldberg, M.D.; Kristy Webster, M.D.; David McManus, M.D.; Michael Kiernan, M.D.; Darleen Lessard, M.D.; Jorge Yarzebski, M.D.; Chad Darling, M.D.; and Joel Gore, M.D.
Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at www.heart.org/corporatefunding.