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. 2022 Feb;9(1):486-495.
doi: 10.1002/ehf2.13720. Epub 2021 Nov 16.

Trends in survival of Swedish men and women with heart failure from 1987 to 2014: a population-based case-control study

Lena Björck  1   2 , Carmen Basic  1 , Christina E Lundberg  1 , Tatiana Zverkova Sandström  3 , Maria Schaufelberger  1   2 , Annika Rosengren  1   2
Affiliations

Trends in survival of Swedish men and women with heart failure from 1987 to 2014: a population-based case-control study

Lena Björck et al. ESC Heart Fail. 2022 Feb.

Abstract

Aims: To compare trends in short-term and long-term survival of patients with heart failure (HF) compared with controls from the general population.

Methods and results: We used data from the Swedish National Inpatient Registry to identify all patients aged ≥18 years with a first recorded diagnosis of HF between 1 January 1987 and 31 December 2014 and compared them with controls matched on age and sex from the Total Population Register. We included 702 485 patients with HF and 1 306 183 controls. In patients with HF aged 18-64 years, short-term (29 days to 6 months) and long-term mortality (>11 years) decreased from 166 and 76.6 per 1000 person-years in 1987 to 2000 to 99.6 and 49.4 per 1000 person-years, respectively, in 2001 to 2014. During the same period, mortality improved marginally, in those aged ≥65 years: short-time mortality from 368.8 to 326.2 per 1000 person-years and long-term mortality from 219.6 to 193.9 per 1000 person-years. In 1987-2000, patients aged <65 years had more than three times higher risk of dying at 29 days to 6 months, with an hazard ratio (HR) of 3.66 [95% confidence interval (CI) 3.46-3.87], compared with controls (P < 0.0001) but substantially higher in 2001-2014 with an HR of 11.3 (95% CI 9.99-12.7, P < 0.0001). HRs for long-term mortality (6-10 and >11 years) increased moderately from 2.49 (95% CI 2.41-2.57) and 3.16 (95% CI 3.07-3.24) in 1987-2000 to 4.35 (95% CI 4.09-4.63) and 4.11 (95% CI 3.49-4.85) in 2001-2014, largely because survival among controls improved more than that among patients with HF (P < 0.0001).

Conclusions: Absolute survival improved in HF patients aged <65 years, but only marginally so in those aged ≥65 years. Compared with controls, both short-term and long-term relative risk of dying increased, especially in younger patients with HF.

Keywords: Epidemiology; Heart failure; Mortality; Population; Survival; Trends.

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Conflict of interest statement

Lena Björck, Carmen Basic, Christina E. Lundberg, Tatiana Zverkova Sandström, Maria Schaufelberger, and Annika Rosengren declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Survival probability after heart failure in patients aged 18–64 years.
Figure 2
Figure 2
Survival probability after heart failure in patients aged ≥65 years.
See this image and copyright information in PMC

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