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Improving survival in the six months after diagnosis of heart failure in the past decade: population-based data from the UK
  1. Paresh A Mehta (p.mehta{at}imperial.ac.uk)
  1. Imperial College London, United Kingdom
    1. Simon W Dubrey (simon.dubrey{at}thh.nhs.uk)
    1. The Hillingdon Hospital, United Kingdom
      1. Hugh F McIntyre (hugh.mcintyre{at}esht.nhs.uk)
      1. The Conquest Hospital, United Kingdom
        1. David M Walker (david.walker{at}esht.nhs.uk)
        1. The Conquest Hospital, United Kingdom
          1. Suzanna M C Hardman (suzanna.hardman{at}whittington.nhs.uk)
          1. UCL, United Kingdom
            1. George C Sutton (georgesutton{at}ukgateway.net)
            1. Dept of Cardiology, Hammersmith Hospital, United Kingdom
              1. Theresa A McDonagh (t.mcdonagh{at}imperial.ac.uk)
              1. Royal Brompton Hospital, United Kingdom
                1. Martin R Cowie (m.cowie{at}imperial.ac.uk)
                1. National Heart & Lung Institute, United Kingdom

                  Abstract

                  Objective: To investigate the secular trend in survival after a new diagnosis of heart failure in the UK population.

                  Design and setting: Comparison of all-cause mortality in the six months' after diagnosis of heart failure in population-based studies in the South east of England in 2004-05 (Hillingdon-Hastings Study) and 1995-97 (Hillingdon-Bromley Studies).

                  Participants: 396 patients in the 2004-05 cohort and 552 patients in the 1995-97 cohort with incident (new) heart failure.

                  Main outcome measures: All-cause mortality.

                  Results: All-cause mortality rates were 6% [95% confidence interval (CI) 3-8%] at 1 month, 11% [8-14%] at 3 months and 14% [11-18%] at 6 months in the 2004-05 cohort compared with 16% [13-20%], 22% [19-25%] and 26% [22-29%], respectively, in the 1995-97 cohort (Difference between the two cohorts, p<0.00001). The difference in survival was not explained by any difference in the demographics or severity of heart failure at presentation. There was a difference at baseline and thereafter in the use of neurohormonal antagonists (b-blockers and ACE inhibitors).

                  Conclusions: Although early mortality remains high among patients with newly diagnosed heart failure in the UK general population, there is strong evidence of a marked improvement in survival from 1995-97 to 2004-05, perhaps partially explained by an increased usage of neurohormonal antagonists.

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