Heart 2000;83:505-510 ( May )

Cardiovascular medicine

Survival of patients with a new diagnosis of heart failure: a population based study M R Cowie^a, D A Wood^a, A J S Coats^a, S G Thompson^b, V Suresh^a, P A Poole-Wilson^a, G C Sutton^a

^a Cardiac Medicine, Imperial College School of Medicine at the National Heart and Lung Institute, London SW3, UK, ^b Department of Medical Statistics and Evaluation, Imperial College School of Medicine, Hammersmith Hospital, London W12, UK

Correspondence to: Dr Martin Cowie, Department of Medicine and Therapeutics, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen AB25 2ZD, UK email: m.cowie{at}abdn.ac.uk

Accepted 31 January 2000

OBJECTIVETo describe the survival of a population based cohort of patients with incident (new) heart failure and the clinical features associated with mortality.
DESIGNA population based observational study.
SETTINGPopulation of 151 000 served by 82 general practitioners in west London.
PATIENTSNew cases of heart failure were identified by daily surveillance of acute hospital admissions to the local district general hospital, and by general practitioner referral of all suspected new cases of heart failure to a rapid access clinic.
INTERVENTIONSAll patients with suspected heart failure underwent clinical assessment, and chest radiography, ECG, and echocardiogram were performed. A panel of three cardiologists reviewed all the data and determined whether the definition of heart failure had been met. Patients were subsequently managed by the general practitioner in consultation with the local cardiologist or admitting physician.
MAIN OUTCOME MEASURESDeath, overall and from cardiovascular causes.
RESULTSThere were 90 deaths (83 cardiovascular deaths) in the cohort of 220 patients with incident heart failure over a median follow up of 16 months. Survival was 81% at one month, 75% at three months, 70% at six months, 62% at 12 months, and 57% at 18 months. Lower systolic blood pressure, higher serum creatinine concentration, and greater extent of crackles on auscultation of the lungs were independently predictive of cardiovascular mortality (all p < 0.001).
CONCLUSIONSIn patients with new heart failure, mortality is high in the first few weeks after diagnosis. Simple clinical features can identify a group of patients at especially high risk of death.


Keywords: heart failure; prognosis; survival; epidemiology

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• Newton, J D, Squire, I B (2006). Glucose and haemoglobin in the assessment of prognosis after first hospitalisation for heart failure. Heart 92: 1441-1446 [Abstract] [Full Text]  
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• Mehta, P A, Cowie, M R (2006). Gender and heart failure: a population perspective. Heart 92: iii14-iii18 [Full Text]  
• de Silva, R., Nikitin, N. P., Witte, K. K.A., Rigby, A. S., Goode, K., Bhandari, S., Clark, A. L., Cleland, J. G.F. (2006). Incidence of renal dysfunction over 6 months in patients with chronic heart failure due to left ventricular systolic dysfunction: contributing factors and relationship to prognosis. Eur Heart J 27: 569-581 [Abstract] [Full Text]  
• Whinnett, Z. I., Davies, J. E.R., Willson, K., Chow, A. W., Foale, R. A., Davies, D. W., Hughes, A. D., Francis, D. P., Mayet, J. (2006). Determination of optimal atrioventricular delay for cardiac resynchronization therapy using acute non-invasive blood pressure.. Europace 8: 358-366 [Abstract] [Full Text]  
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• Goldacre, M. J, Mant, D., Duncan, M., Griffith, M. (2005). Mortality from heart failure in an English population, 1979-2003: study of death certification. J. Epidemiol. Community Health 59: 782-784 [Abstract] [Full Text]  
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• Lacey, L., Tabberer, M. (2005). Economic burden of post-acute myocardial infarction heart failure in the United Kingdom. Eur J Heart Fail 7: 677-683 [Abstract] [Full Text]  
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• Gustafsson, F., Torp-Pedersen, C., Seibaek, M., Burchardt, H., Kober, L., for the DIAMOND study group, (2004). Effect of age on short and long-term mortality in patients admitted to hospital with congestive heart failure. Eur Heart J 25: 1711-1717 [Abstract] [Full Text]  
• Bleumink, G. S., Knetsch, A. M., Sturkenboom, M. C.J.M., Straus, S. M.J.M., Hofman, A., Deckers, J. W., Witteman, J. C.M., Stricker, B. H.Ch. (2004). Quantifying the heart failure epidemic: prevalence, incidence rate, lifetime risk and prognosis of heart failure: The Rotterdam Study. Eur Heart J 25: 1614-1619 [Abstract] [Full Text]  
• Jones, R.C., Francis, G. S., Lauer, M. S. (2004). Predictors of mortality in patients with heart failure and preserved systolic function in the Digitalis Investigation Group trial. J Am Coll Cardiol 44: 1025-1029 [Abstract] [Full Text]  
• Raymond, I., Mehlsen, J., Pedersen, F., Dimsits, J., Jacobsen, J., Hildebrandt, P. R. (2004). The prognosis of impaired left ventricular systolic function and heart failure in a middle-aged and elderly population in an urban population segment of Copenhagen. Eur J Heart Fail 6: 653-661 [Abstract] [Full Text]  
• Lenzen, M.J, Scholte op Reimer, W.J.M, Boersma, E, Vantrimpont, P.J.M.J, Follath, F, Swedberg, K, Cleland, J, Komajda, M (2004). Differences between patients with a preserved and a depressed left ventricular function: a report from the EuroHeart Failure Survey. Eur Heart J 25: 1214-1220 [Abstract] [Full Text]  
• Shah, S, Davies, M K, Cartwright, D, Nightingale, P (2004). Management of chronic heart failure in the community: role of a hospital based open access heart failure service. Heart 90: 755-759 [Abstract] [Full Text]  
• Luthi, J.-C., Flanders, W. D., Pitts, S. R., Burnand, B., McClellan, W. M. (2004). Outcomes and the quality of care for patients hospitalized with heart failure. Int J Qual Health Care 16: 201-210 [Abstract] [Full Text]  
• Banerjee, P., Clark, A. L., Nikitin, N., Cleland, J. G.F. (2004). Diastolic heart failure. Paroxysmal or chronic?. Eur J Heart Fail 6: 427-431 [Abstract] [Full Text]  
• Willenheimer, R., Erdmann, E., Follath, F., Krum, H., Ponikowski, P., Silke, B., van Veldhuisen, D. J., van de Ven, L., Verkenne, P., Lechat, P., on behalf of the CIBIS-III investigators, (2004). Comparison of treatment initiation with bisoprolol vs. enalapril in chronic heart failure patients: rationale and design of CIBIS-III. Eur J Heart Fail 6: 493-500 [Abstract] [Full Text]  
• Kalantar-Zadeh, K., Block, G., Horwich, T., Fonarow, G. C. (2004). Reverse epidemiology of conventional cardiovascular risk factors in patients with chronic heart failure. J Am Coll Cardiol 43: 1439-1444 [Abstract] [Full Text]  
• Gustafsson, I., Brendorp, B., Seibaek, M., Burchardt, H., Hildebrandt, P., Kober, L., Torp-Pedersen, C., DIAMOND Study Group, (2004). Influence of diabetes and diabetes-gender interaction on the risk of death in patients hospitalized with congestive heart failure. J Am Coll Cardiol 43: 771-777 [Abstract] [Full Text]  
• Tendera, M. (2004). The epidemiology of heart failure. Journal of Renin-Angiotensin-Aldosterone System 5: S2-S6 [Abstract]  
• Formiga, F., Chivite, D., Manito, N., Osma, V., Miravet, S., Pujol, R. (2004). One-year follow-up of heart failure patients after their first admission. QJM 97: 81-86 [Abstract] [Full Text]  
• Dowling, R. D., Gray, L. A. Jr, Etoch, S. W., Laks, H., Marelli, D., Samuels, L., Entwistle, J., Couper, G., Vlahakes, G. J., Frazier, O. H. (2004). Initial experience with the AbioCor Implantable Replacement Heart System. J. Thorac. Cardiovasc. Surg. 127: 131-141 [Abstract] [Full Text]  
• Lyratzopoulos, G, Heller, R F (2003). Prognosis for South Asian and white patients with heart failure in the United Kingdom: Deprivation gradient in mortality should not be dismissed as artefactual. BMJ 327: 1406-1406 [Full Text]  
• Meluzin, J, Spinarova, L, Dusek, L, Toman, J, Hude, P, Krejci, J (2003). Prognostic Importance of the Right Ventricular Function Assessed by Doppler Tissue Imaging. Eur J Echocardiogr 4: 262-271 [Abstract] [Full Text]  
• Wright, S. P., Doughty, R. N., Pearl, A., Gamble, G. D., Whalley, G. A., Walsh, H. J., Gordon, G., Bagg, W., Oxenham, H., Yandle, T., Richards, M., Sharpe, N. (2003). Plasma amino-terminal pro-brain natriuretic peptide and accuracy of heart-failure diagnosis in primary care: A randomized, controlled trial. J Am Coll Cardiol 42: 1793-1800 [Abstract] [Full Text]  
• Wendelboe Nielsen, O, Hilden, J, McDonagh, T, Fischer Hansen, J (2003). Survival differences between heart failure in general practices and in hospitals. Heart 89: 1298-1302 [Abstract] [Full Text]  
• Murray-Thomas, T., Cowie, M. R (2003). Epidemiology and clinical aspects of congestive heart failure. Journal of Renin-Angiotensin-Aldosterone System 4: 131-136 [Abstract]  
• Cowie, M R (2003). Estimating prognosis in heart failure: time for a better approach. Heart 89: 587-588 [Full Text]  
• Bouvy, M L, Heerdink, E R, Leufkens, H G M, Hoes, A W (2003). Predicting mortality in patients with heart failure: a pragmatic approach. Heart 89: 605-609 [Abstract] [Full Text]  
• Blackledge, H M, Tomlinson, J, Squire, I B (2003). Prognosis for patients newly admitted to hospital with heart failure: survival trends in 12 220 index admissions in Leicestershire 1993-2001. Heart 89: 615-620 [Abstract] [Full Text]  
• Chow, A. W C, Lane, R. E, Cowie, M. R (2003). New pacing technologies for heart failure. BMJ 326: 1073-1077 [Full Text]  
• Gustafsson, F., Torp-Pedersen, C., Brendorp, B., Seibaek, M., Burchardt, H., Kober, L., for the DIAMOND study group, (2003). Long-term survival in patients hospitalized with congestive heart failure: relation to preserved and reduced left ventricular systolic function. Eur Heart J 24: 863-870 [Abstract] [Full Text]  
• Cleland, J.G.F, Swedberg, K, Follath, F, Komajda, M, Cohen-Solal, A, Aguilar, J.C, Dietz, R, Gavazzi, A, Hobbs, R, Korewicki, J, Madeira, H.C, Moiseyev, V.S, Preda, I, van Gilst, W.H, Widimsky, J, for the Study Group on Diagnosis of the Working Gr, , Freemantle, N, Eastaugh, J., Mason, J (2003). The EuroHeart Failure survey programme--a survey on the quality of care among patients with heart failure in Europe: Part 1: patient characteristics and diagnosis. Eur Heart J 24: 442-463 [Abstract] [Full Text]  
• Poole-Wilson, P A, Uretsky, B F, Thygesen, K, Cleland, J G F, Massie, B M, Ryden, L (2003). Mode of death in heart failure: findings from the ATLAS trial. Heart 89: 42-48 [Abstract] [Full Text]  
• Cleland, J.G.F., Takala, A., Apajasalo, M., Zethraeus, N., Kobelt, G. (2003). Intravenous levosimendan treatment is cost-effective compared with dobutamine in severe low-output heart failure: an analysis based on the international LIDO trial. Eur J Heart Fail 5: 101-108 [Abstract] [Full Text]  
• Cowie, M.R. (2002). The fine art of prognostication. Eur Heart J 23: 1804-1806 [Full Text]  
• Archana, R., Gray, D. (2002). The quality of life in chronic disease--heart failure is as bad as it gets. Eur Heart J 23: 1806-1808 [Full Text]  
• Muntwyler, J., Abetel, G., Gruner, C., Follath, F. (2002). One-year mortality among unselected outpatients with heart failure. Eur Heart J 23: 1861-1866 [Abstract] [Full Text]  
• Pugh, P. J., Jones, R. D., Jones, T.H., Channer, K. S. (2002). Heart failure as an inflammatory condition: potential role for androgens as immune modulators. Eur J Heart Fail 4: 673-680 [Abstract] [Full Text]  
• Silverberg, D. S., Wexler, D., Iaina, A. (2002). The importance of anemia and its correction in the management of severe congestive heart failure. Eur J Heart Fail 4: 681-686 [Abstract] [Full Text]  
• Cowie, M R (2002). Best practice: evidence from the clinical trials. Heart 88: ii2-4 [Full Text]  
• Wood, D A (2002). Preventing clinical heart failure: the rationale and scientific evidence. Heart 88: ii15-22 [Full Text]  
• McIntyre, H F, Barrett, J, Murphy, S, Wray, R, Sutcliffe, S J, Walker, D M (2002). Across the interface: the Hastings Heart Function Clinic. Heart 88: ii23-27 [Full Text]  
• Hardman, S M C (2002). Heart failure: across the interface and beyond. Heart 88: ii28-32 [Full Text]  
• Gibbs, J S R, McCoy, A S M, Gibbs, L M E, Rogers, A E, Addington-Hall, J M (2002). Living with and dying from heart failure: the role of palliative care. Heart 88: ii36-39 [Full Text]  
• Mahon, N. G., Blackstone, E. H., Francis, G. S., Starling, R. C. III, Young, J. B., Lauer, M. S. (2002). The prognostic value of estimated creatinine clearance alongside functional capacity in ambulatory patients with chronic congestive heart failure. J Am Coll Cardiol 40: 1106-1113 [Abstract] [Full Text]  
• Seamark, D. A, Ryan, M., Smallwood, N., Gilbert, J. (2002). Deaths from heart failure in general practice: implications for palliative care. Palliat Med 16: 495-498 [Abstract]  
• McClellan, W. M., Flanders, W. D., Langston, R. D., Jurkovitz, C., Presley, R. (2002). Anemia and Renal Insufficiency Are Independent Risk Factors for Death among Patients with Congestive Heart Failure Admitted to Community Hospitals: A Population-Based Study. J. Am. Soc. Nephrol. 13: 1928-1936 [Abstract] [Full Text]  
• Cowie, M. R., Fox, K. F., Wood, D. A., Metcalfe, C., Thompson, S. G., Coats, A. J. S., Poole-Wilson, P. A., Sutton, G. C. (2002). Hospitalization of patients with heart failure. A population-based study. Eur Heart J 23: 877-885 [Abstract] [Full Text]  
• Azevedo, A., Pimenta, J., Dias, P., Bettencourt, P., Ferreira, A., Cerqueira-Gomes, M. (2002). Effect of a heart failure clinic on survival and hospital readmission in patients discharged from acute hospital care. Eur J Heart Fail 4: 353-359 [Abstract] [Full Text]  
• Stewart, S., Demers, C., Murdoch, D.R., McIntyre, K., MacLeod, M.E., Kendrick, S., Capewell, S., McMurray, J.J.V. (2002). Substantial between-hospital variation in outcome following first emergency admission for heart failure. Eur Heart J 23: 650-657 [Abstract] [Full Text]  
• Cowie, M.R. (2002). A reply. Eur Heart J 23: 425-425 [Full Text]  
• Banerjee, P., Banerjee, T., Khand, A., Clark, A. L., Cleland, J. G. F. (2002). Diastolic heart failure: neglected or misdiagnosed?. J Am Coll Cardiol 39: 138-141 [Abstract] [Full Text]  
• Task Force for the Diagnosis and Treatment of Chro, , Remme, W. J., Swedberg, K. (2001). Guidelines for the diagnosis and treatment of chronic heart failure. Eur Heart J 22: 1527-1560  
• Cowie, M.R. (2001). The prognosis of heart failure: the view from the real world. Eur Heart J 22: 1247-1248 [Abstract]  
• Mosterd, A, Cost, B, Hoes, A.W, de Bruijne, M.C, Deckers, J.W, Hofman, A, Grobbee, D.E (2001). The prognosis of heart failure in the general population. The Rotterdam Study. Eur Heart J 22: 1318-1327 [Abstract]  
• Wood, D.A., Fox, K.F., Gibbs, S.R. (2001). Rapid cardiology--for chest pain, breathlessness and palpitations. QJM 94: 177-178 [Full Text]  
• Zannad, F. (2001). Have we jugulated the epidemic of heart failure? One swallow does not make a summer . . .. Eur Heart J 22: 188-190  
• Khand, A., Gemmel, I., Clark, A. L., Cleland, J. G. F. (2000). Is the prognosis of heart failure improving?. J Am Coll Cardiol 36: 2284-2286 [Full Text]  
• Fox, K. F., Cowie, M. R., Wood, D. A., Coats, A. J.S., Poole-Wilson, P. A., Sutton, G. C. (2000). A Rapid Access Heart Failure Clinic provides a prompt diagnosis and appropriate management of new heart failure presenting in the community. Eur J Heart Fail 2: 423-429 [Abstract] [Full Text]  
• Addington-Hall, J. M, Gibbs, J S. R (2000). Heart failure now on the palliative care agenda. Palliat Med 14: 361-362  
• GREAVES, S. C (2000). Assessment of left ventricular systolic function in research and in clinical practice. Heart 83: 493-494 [Full Text]  

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Survival of patients with a first hospital admission for heart failure

Kate MacIntyre

Online, 9 May 2000 [Full text]