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. 2014 Jan;35(1):25-32.
doi: 10.1093/eurheartj/eht278. Epub 2013 Jul 29.

Heart failure in young adults: 20-year trends in hospitalization, aetiology, and case fatality in Sweden

Anders Barasa  1 , Maria Schaufelberger, Georgios Lappas, Karl Swedberg, Mikael Dellborg, Annika Rosengren
Affiliations

Heart failure in young adults: 20-year trends in hospitalization, aetiology, and case fatality in Sweden

Anders Barasa et al. Eur Heart J. 2014 Jan.

Abstract

Aims: To describe trends in incidence and case fatality among younger (18-54 years) and older (55-84 years) Swedish patients with heart failure (HF).

Methods and results: Through linking the Swedish national hospital discharge and the cause-specific death registries, we identified patients aged 18-84 years that were discharged 1987-2006 with a diagnosis of HF. Age-specific mean incidence rates per 100 000 person-years were calculated in four 5-year periods. Kaplan-Meier survival curves were plotted up to 3 years. From 1987 to 2006, there were 443 995 HF hospitalizations among adults 18-84 years. Of these, 4660 (1.0%) and 13 507 (3.0%) occurred in people aged 18-44 and 45-54 years (31.6% women), respectively. From the first to the last 5-year period, HF incidence increased by 50 and 43%, among people aged 18-34 and 35-44 years, respectively. Among people ≥45 years, incidence peaked in the mid-1990s and then decreased. Heart failure in the presence of cardiomyopathy increased more than two-fold among all age groups. Case fatality decreased for all age groups until 2001, after which no further significant decrease <55 years was observed.

Conclusion: Increasing HF hospitalization in young adults in Sweden opposes the general trend seen in older patients, a finding which may reflect true epidemiological changes. Cardiomyopathy accounted for a substantial part of this increase. High case fatality and lack of further case fatality reduction after 2001 are causes for concern.

Keywords: Comorbidity; Heart failure; Incidence; Prognosis; Young adults.

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Figures

Figure 1
Figure 1
Comorbid prevalence (%) of mutually exclusive diagnoses among heart failure patients of different ages.
Figure 2
Figure 2
Kaplan–Meier survival curves. One-year case fatality after first heart failure hospitalization.
See this image and copyright information in PMC

Comment in

  • Do we need clinical registries?
    Tavazzi L. Tavazzi L. Eur Heart J. 2014 Jan;35(1):7-9. doi: 10.1093/eurheartj/eht360. Epub 2013 Sep 7. Eur Heart J. 2014. PMID: 24014383 No abstract available.

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