Heart failure in young adults is associated with high mortality: a contemporary population-level analysis

Abstract Background Data on young patients with heart failure (HF) are sparse. We examined the characteristics, health care use, and survival of younger vs older patients with HF. Methods We performed an analysis of linked administrative databases in Alberta, Canada. We identified 34,548 patients who had a first hospitalization for HF as the principal diagnosis from 2002-2014. Patients were stratified into 4 age groups: 20-44, 45-54, 55-64, and ≥ 65 years. Results Of the 34,548 patients, 496 (1.4%), 1319 (3.8%), 3359 (9.7%), and 29,374 (85%) were aged 20-44, 45-54, 55-64, and ≥ 65 years, respectively. The incidence of HF hospitalization decreased over time among patients ≥ 65 years and increased among men aged 20-64 years. In the year after the index HF hospitalization, compared with older patients, younger patients were less likely to present to the emergency department (ED) (eg, 67.2% of those aged 20-44 years vs 74.8% of those aged ≥ 65 years) or to be hospitalized for any reason (48.5% vs 61.2%), cardiovascular causes (28.6% vs 34.4%), or HF (14.8% vs 23.6%). Mortality rates were lower in younger patients aged 20-44 years but were still substantial: 3.9%, 12.4%, and 27.7% at 30 days, 1 year, and 5 years, respectively. Conclusions Although young patients, especially those < 45 years of age, accounted for a small proportion of the total population, adverse events were frequent, with half of the younger patients being readmitted, two-thirds presenting to an ED, and > 10% dying within a year.