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Læknablaðið - 01.10.2017, Blaðsíða 36

Læknablaðið - 01.10.2017, Blaðsíða 36
436 LÆKNAblaðið 2017/103 R A N N S Ó K N ENGLISH SUMMARY Introduction: Heart failure (HF) is a common and a serious condition that predominantly affects elderly people. On the basis of the left ventricular ejection fraction (EF) it can be divided into HF with reduced or preserved ejection fraction (HFrEF and HFpEF, respectively). The goal of this study was to investigate the prevalence and incidence of HF among elderly Icelanders, explore underlying diseases and estimate the effect of HF on overall survival. Material and methods: Included were 5706 participants of the AGES study. The hospital records of those diagnosed with HF before entry into AGES were used to calculate prevalence and the records of those diagnosed from entry into AGES until 28.2.2010 were used to calculate incidence. All cases of HF were verified according to predetermined criteria for diagnosis. Information on underlying diseases and EF of HF patients were obtained from hospital records. Survival was estimated using Kaplan-Meier survival curves. Results: Lifetime prevalence of HF was 3.6% as of 2004, higher among men than women (p<0,001). The incidence was 16.2 cases per 1000 person-years, higher among men than among women (p<0,001). The incidence of HFrEF was 6.1 per 1000 person-years also higher among men than women (p<0,001). The incidence of HFpEF was 6.8 per 1000 person-years and there was no statistical difference between the sexes (p=0.62). The age adjusted 5-year survival rate of HF-patients was 32.5%, there was no statistical difference in relative survival between men and women (p=0.46). There was no statistical difference between the survival of patients with HFrEF and those with HFpEF (p=0.52). Conclusion: Both prevalence and incidence of HF are high among eld- erly Icelanders, increasing sharply with age and 5-year survival rate is only around 30%. While men are more likely to develop HF, especially HFrEF, women are more likely to be diagnosed with HFpEF. Heart failure among elderly Icelanders: Incidence, prevalence, underlying diseases and long-term survival Haukur Einarsson1, Guðmundur Þorgeirsson1,2,3, Ragnar Danielsen1,2 , Örn Ólafsson3, Thor Aspelund1,3, Vilmundur Guðnason1,3 1University of Iceland Medicine, 2Landspítali University Hospital, 3Icelandic Heart Association Keywords: heart failure, HFrEF, HFpEF og AGES-Reykjavik Study. Correspondence: Haukur Einarsson haukure77@gmail.com Heimildir 1. Borlaug BA, Redfield MM. Diastolic and systolic heart failure are distinct phenotypes within the heart failure spectrum. Circulation 2011;123:2006-13; discussion 14. 2. Bui AL, Horwich TB, Fonarow GC. Epidemiology and risk profile of heart failure. Nature reviews Cardiology 2011;8:30-41. 3. Senni M, Tribouilloy CM, Rodeheffer RJ, Jacobsen SJ, Evans JM, Bailey KR, et al. Congestive heart failure in the community: trends in incidence and survival in a 10-year period. Archives of internal medicine 1999;159:29-34. 4. 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Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Jr., Drazner MH, et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Journal of the American College of Cardiology 2013;62:e147-239. 10. Zarrinkoub R, Wettermark B, Wandell P, Mejhert M, Szulkin R, Ljunggren G, et al. The epidemiology of heart failure, based on data for 2.1 million inhabitants in Sweden. European journal of heart failure 2013;15:995- 1002. 11. Mosterd A, Hoes AW, de Bruyne MC, Deckers JW, Linker DT, Hofman A, et al. Prevalence of heart failure and left ventricular dysfunction in the general population; The Rotterdam Study. European heart journal 1999;20:447-55. 12. Mehta PA, Cowie MR. Gender and heart failure: a population perspective. Heart 2006;92 Suppl 3:iii14-8. 13. Stromberg A, Martensson J. Gender differences in patients with heart failure. European journal of cardiovascular nursing : journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology 2003;2:7- 18. 14. Owan TE, Redfield MM. Epidemiology of diastolic heart failure. Progress in cardiovascular diseases 2005;47:320- 32. 15. Harris TB, Launer LJ, Eiriksdottir G, Kjartansson O, Jonsson PV, Sigurdsson G, et al. Age, Gene/Environment Susceptibility-Reykjavik Study: multidisciplinary app- lied phenomics. American journal of epidemiology 2007;165:1076-87. 16. Danielsen R, Aspelund T, Harris TB, Gudnason V. The prevalence of aortic stenosis in the elderly in Iceland and predictions for the coming decades: the AGES-Reykjavik study. International journal of cardiology 2014;176:916-22. 17. RStudio: Integrated Development for R. RStudio, Inc. 3.1.3 ed. Boston, MA: RStudio Team; 2015. 18. StataCorp. Stata Statistical Software: Release 13. College Station, TX: StataCorp LP; 2013. 19. Sigbergsdottir A, Sigurdsson AF. Hjartabilun með varð- veitta slegilvirkni (hlébilsbilun). Samanburður á hlé- og slagbilsbilun. Læknablaðið 2006;Fylgirit 52 V1. 20. Thrainsdottir IS, Aspelund T, Thorgeirsson G, Gudnason V, Hardarson T, Malmberg K, et al. The association between glucose abnormalities and heart failure in the population-based Reykjavik study. Diabetes care 2005;28:612-6. 21. Mosterd A, Hoes AW. Clinical epidemiology of heart failure. Heart 2007;93:1137-46. 22. Redfield MM, Jacobsen SJ, Burnett JC, Jr., Mahoney DW, Bailey KR, Rodeheffer RJ. Burden of systolic and diastolic ventricular dysfunction in the community: appreciating the scope of the heart failure epidemic. Jama 2003;289:194- 202. 23. Curtis LH, Whellan DJ, Hammill BG, Hernandez AF, Anstrom KJ, Shea AM, et al. Incidence and prevalence of heart failure in elderly persons, 1994-2003. Archives of internal medicine 2008;168:418-24. 24. Cowie MR, Wood DA, Coats AJ, Thompson SG, Poole- Wilson PA, Suresh V, et al. Incidence and aetiology of heart failure; a population-based study. European heart journal 1999;20:421-8. 25. Gottdiener JS, Arnold AM, Aurigemma GP, Polak JF, Tracy RP, Kitzman DW, et al. Predictors of congestive heart failure in the elderly: the Cardiovascular Health Study. Journal of the American College of Cardiology 2000;35:1628-37. 26. Komamura K. Similarities and Differences between the Pathogenesis and Pathophysiology of Diastolic and Systolic Heart Failure. Cardiology research and practice 2013;2013:824135. 27. Loehr LR, Rosamond WD, Chang PP, Folsom AR, Chambless LE. Heart failure incidence and survival (from the Atherosclerosis Risk in Communities study). The American journal of cardiology 2008;101:1016-22. 28. Ho KK, Anderson KM, Kannel WB, Grossman W, Levy D. Survival after the onset of congestive heart failure in Framingham Heart Study subjects. Circulation 1993;88:107-15. 29. Simon T, Mary-Krause M, Funck-Brentano C, Jaillon P. Sex differences in the prognosis of congestive heart failure: results from the Cardiac Insufficiency Bisoprolol Study (CIBIS II). Circulation 2001;103:375-80. 30. Owan TE, Hodge DO, Herges RM, Jacobsen SJ, Roger VL, Redfield MM. Trends in prevalence and outcome of heart failure with preserved ejection fraction. The New England journal of medicine 2006;355:251-9. 31. Senni M, Redfield MM. Heart failure with preserved systolic function. A different natural history? Journal of the American College of Cardiology 2001;38:1277-82. 32. Dunlay SM, Weston SA, Jacobsen SJ, Roger VL. Risk factors for heart failure: a population-based case-control study. The American journal of medicine 2009;122:1023-8.
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