DOI: 10.3724/SP.J.1263.2012.10021

Journal of Geriatric Cardiology 2012/9:4 PP.361-365

Secular trends in the etiology and comorbidity of hospitalized patients with congestive heart failure: A single-center retrospective study

Objective To assess the secular trends in the etiology and comorbidity of patients hospitalized with congestive heart failure (CHF). Methods Data of 7,319 patients (mean age 59.6 years, 62.1% male) with a primary discharge diagnosis of CHF, hospitalized from January 1, 1993 to December 31, 2007 at the Chinese People’s Liberation Army (PLA) General Hospital were extracted and analyzed. These patients were divided into three groups according to hospitalization period: 1993–1997 (n = 1623), 1998–2002 (n = 2444), and 2003–2007 (n = 3252). The etiological characteristics and comorbidities were assessed. Results Over the study period, the proportion of patients with ischemic heart disease (IHD) increased from 37.2% during the period 1993–1997 to 46.8% during the period 2003–2007, while that with valvular heart disease (VHD) decreased from 35.2% during the period 1993–1997 to 16.6% during the period 2003–2007 (both P < 0.05). Atrial fibrillation (AF) was the most common comorbidity of heart failure (23.2%, 23.0% and 20.6%, respectively, in the three periods). Compared to that of the period of 1993–1997 with that of, the proportion of patients with myocardial infarction, pneumonia, renal function impairment and hepatic cirrhosis of the period of 2003–2007 increased significantly (P < 0.05) and the proportion of patients with chronic obstructive pulmonary disease and atrial fibrillation decreased significantly (P < 0.05). Conclusions This study implies that IHD has became a more common etiology of CHF, while VHD has deceased as an etiology of CHF in Chinese patients during the last two decades.

Key words:Atrial fibrillation,Congestive heart failure,Comorbidity,Etiology,Hospitalization

ReleaseDate:2014-07-21 16:32:12

1 Jessup M, Brozena S. Heart failure. N Engl J Med 2003; 348: 2007-2018.

2 Huynh BC, Rovner A, Rich MW. Long-term survival in elderly patients hospitalized for heart failure: 14-year follow-up from a prospective randomized trial. Arch Intern Med 2006; 166: 1892-1898.

3 Massie BM, Shah NB. Evolving trends in the epidemiologic factors of heart failure: rationale for preventive strategies and comprehensive disease management. Am Heart J 1997; 33: 703-712.

4 Levy D, Kenchaiah S, Larson MG, et al. Long-term trends in the incidence of and survival with heart failure. N Engl J Med 2002; 347: 1397-1402.

5 Tsutsui H, Tsuchihashi-Makaya M, Kinugawa S, et al. JCARE-GENERAL Investigators. Characteristics and outcomes of patients with heart failure in general practices and hospitals. Circ J 2007; 71: 449-454.

6 Cohen-Solal A, Desnos M, Delahaye F, et al. A national survey of heart failure in French hospitals. Eur Heart J 2000; 21: 763-769.

7 Koseki Y, Watanabe J, Shinozaki T, et al. Characteristics and 1-year prognosis of medically treated patients with chronic heart failure in Japan. Circ J 2003; 67: 431-436.

8 Pulignano G, Del Sindaco D, Tavazzi L, et al. Clinical features and outcomes of elderly outpatients with heart failure followed up in hospital cardiology units: Data from a large nationwide cardiology database (IN-CHF Registry). Am Heart J 2002; 143: 45-55.

9 Mosterd A, Cost B, Hoes AW, et al. The prognosis of heart failure in the general population: The Rotterdam Study. Eur Heart J 2001; 22: 1318-1327.

10 Goldberg RJ, Ciampa J, Lessard D, et al. Long-term survival after heart failure: a contemporary population-based perspective. Arch Intern Med 2007; 167: 490-496.

11 Cowie MR, Wood DA, Coats AJ, et al. Survival of patients with a new diagnosis of heart failure: a population based study. Heart 2000; 83: 505-510.

12 Ko DT, Tu JV, Masoudi FA, et al. Quality of care and outcomes of older patients with heart failure hospitalized in the United States and Canada. Arch Intern Med 2005; 165: 2486-2492.

13 Deswal A, Petersen NJ, Urbauer DL, et al. Racial variations in quality of care and outcomes in an ambulatory heart failure cohort. Am Heart J 2006; 152: 348-354.

14 Newton JD, Blackledge HM, Squire IB. Ethnicity and variation in prognosis for patients newly hospitalised for heart failure: a matched historical cohort study. Heart 2005; 91: 1545-1550.

15 International Classification of Diseases, Ninth Revision, Clinical Modification. Washington, D.C.: Public Health Service, U.S. Department of Health and Human Services; 1988.

16 Folsom AR, Yamagishi K, Hozawa A, et al. Absolute and attributable risks of heart failure incidence in relation to optimal risk factors. Circ Heart Fail 2009; 2: 11-17.

17 Zannad F, Briancon S, Juilliere Y, et al. Incidence, clinical and etiologic features, and outcomes of advanced chronic heart failure: the EPICAL Study. Epidémiologie de l'Insuffisance Cardiaque Avancée en Lorraine. J Am Coll Cardiol 1999; 33: 734-742.

18 Tsuchihashi M, Tsutsui H, Kodama K, et al. Clinical charac-teristics and prognosis of hospitalized patients with congestive heart--a study in Fukuoka, Japan. Jpn Circ J 2000; 64: 953-959.

19 Adams KF Jr., Fonarow GC, Emerman CL, et al. Characteristics and outcomes of patients hospitalized for heart failure in the United States: rationale, design, and preliminary observations from the first 100,000 cases in the acute decompensated heart failure national registry (ADHERE). Am Heart J 2005; 149: 209-216.

20 Goda A, Yamashita T, Suzuki S, et al. Prevalence and prognosis of patients with heart failure in Tokyo: a prospective cohort of Shinken Database 2004-5. Int Heart J 2009; 50: 609-625.

21 Vora A. Management of atrial fibrillation in rheumatic valvular heart disease. Curr Opin Cardiol 2006; 21: 47-50.

22 Cao YM, Hu DY, Wu Y, et al. A pilot survey of the main causes of chronic heart failure in patients treated in primary hospitals in China. Zhonghua Nei Ke Za Zhi 2005; 44: 487-489.

23 Shanghai Investigation Group of Heart Failure. The evolving trends in the epidemiologic factors and treatment of hospitalized patients with congestive heart failure in Shanghai during the years of 1980, 1990 and 2000. Zhonghua Xin Xue Guan Bing Za Zhi 2002; 30: 24-26.

24 Swedberg K, Olsson LG, Charlesworth A, et al. Prognostic relevance of atrial fibrillation in patients with chronic heart failure on long-term treatment with betablockers: Results from COMET. Eur Heart J 2005; 26: 1303-1308.

25 Rusinaru D, Leborgne L, Peltier M, et al. Effect of atrial fibrillation on long-term survival in patients hospitalised for heart failure with preserved ejection fraction. Eur J Heart Fail 2008; 10: 566-572.

26 Yang JF, Liu B, Liu DG, et al. Prevalence and risk factors of atrial fibrillation in preterminal inpatients aged 60 years and over. Chin Med J (Engl) 2008; 121: 2046-2049.

27 Smith GL, Lichtman JH, Bracken MB, et al. Renal impairment and outcomes in heart failure. J Am Coll Cardiol 2006; 47: 1987-1996.

28 Sarraf M, Masoumi A, Schrier RW. Cardiorenal syndrome in acute decompensated heart failure. Clin J Am Soc Nephrol 2009; 4: 2013-2026.