Thumbnail Image
Item

The survival of patients with heart failure with preserved or reduced left ventricular ejection fraction : an individual patient data meta-analysis : meta-analysis global group in chronic heart failure (maggic)

Stewart, S.
; 
Cubbon, R.
; 
Ezekowitz, Justin
; 
González-Juanatey, José Ramón
; 
Gorini, M.
; 
Gotsman, I.
; 
Grigorian Shamagian, L.
; 
Guazzi, M.
; 
Kearney, M.
; 
Kober, Lars
... show 10 more
Citations
Google Scholar:
Lookup
Altmetric:
Author
Stewart, S.
Cubbon, R.
Ezekowitz, Justin
González-Juanatey, José Ramón
Gorini, M.
Gotsman, I.
Grigorian Shamagian, L.
Guazzi, M.
Kearney, M.
Kober, Lars
Komajda, Michel
Di Lenarda, A.
Lenzen, Mattie
Lucci, D.
McMurray, John
Macín, S.
Madsen, B.
Maggioni, Aldo
Martinez-Selles, Manuel
McAlister, Finlay
Oliva, F.
Poppe, K.
Rich, Michael
Richards, M.
Senni, Michele
Squire, Iain
Taffet, G.
Tarantini, L.
Tribouilloy, Christophe
Troughton, R.
Tsutsui, Hiroyuki
Whalley, Gillian A.
Earle, Nikki
Perera, K.
Poppe, Katrina K.
Dobson, J.
Pocock, Stuart
Andersson, B.
Hall, C.
Richards, A.M.
Lainchbury, J.
Berry, C.
Hogg, K.
Norrie, J.
Stevenson, K.
Brett, M.
Pfeffer, Marc A.
Sweberg, Karl
Granger, Christopher B.
Held, P.
Michelson, Eric L.
Olofsson, B.
O¨ stergren, J.
Yusuf, Salim
Dobson, Joanna
Abstract
Aims A substantial proportion of patients with heart failure have preserved left ventricular ejection fraction (HF-PEF). Previous studies have reported mixed results whether survival is similar to those patients with heart failure and reduced EF (HF-REF). Methods and results We compared survival in patients with HF-PEF with that in patients with HF-REF in a meta-analysis using individual patient data. Preserved EF was defined as an EF ≥ 50%. The 31 studies included 41 972 patients: 10 347 with HF-PEF and 31 625 with HF-REF. Compared with patients with HF-REF, those with HF-PEF were older (mean age 71 vs. 66 years), were more often women (50 vs. 28%), and have a history of hypertension (51 vs. 41%). Ischaemic aetiology was less common (43 vs. 59%) in patients with HF-PEF. There were 121 [95% confidence interval (CI): 117, 126] deaths per 1000 patient-years in those with HF-PEF and 141 (95% CI: 138, 144) deaths per 1000 patient-years in those with HF-REF. Patients with HF-PEF had lower mortality than those with HF-REF (adjusted for age, gender, aetiology, and history of hypertension, diabetes, and atrial fibrillation); hazard ratio 0.68 (95% CI: 0.64, 0.71). The risk of death did not increase notably until EF fell below 40%. Conclusion Patients with HF-PEF have a lower risk of death than patients with HF-REF, and this difference is seen regardless of age, gender, and aetiology of HF. However, absolute mortality is still high in patients with HF-PEF highlighting the need for a treatment to improve prognosis.
Keywords
Heart failure, Prognosis, Meta-analysis
Date
2013
Type
Journal article
Journal
Book
Volume
33
Issue
14
Page Range
1750-1757
Article Number
ACU Department
Collections
Non-faculty - General
Show all metadata
Files
McMurray_2011_The_survival_of_patients_with_heart.pdf
Adobe PDF, 309 KB
All rights reserved
  • Embargoed until 9999-12-31
SM_McMurray_2011_The_survival_of_patients_with_heart.pdf
Adobe PDF, 1.13 MB
All rights reserved
  • Embargoed until 9999-12-31
URI
https://hdl.handle.net/20.500.14802/5333
Relation URI
DOI
10.1093/eurheartj/ehr254
Source URL
https://academic.oup.com/eurheartj/article/33/14/1750/525898#8227196
Event URL
Open Access Status
License
File Access
Controlled
Controlled
Notes
Copyright The Author 2011.
The MAGGIC meta-analysis was supported by grants from the New Zealand National Heart Foundation, The University of Auckland and The University of Glasgow. These sponsors had no role in the design, conduct, data management, and analysis; or in the manuscript preparation or review; or in the authorization for submission.