Young patients with heart failure: clinical characteristics and outcomes. Data from the Swedish Heart Failure, National Patient, Population and Cause of Death Registers. (3rd August 2020)

• Record Type: Journal Article
• Authors: Basic, Carmen; Rosengren, Annika; Alehagen, Urban; Dahlström, Ulf; Edner, Magnus; Fu, Michael; Novak, Masuma; Zverkova Sandström, Tatiana; Schaufelberger, Maria
• Is Part Of: European journal of heart failure. Volume 22:Number 7(2020)
• Page Start: 1125
• Page End: 1132
• Publication Date: 2020-08-03
• Subjects: Heart failure -- Young adults -- Comorbidity -- Mortality; Heart failure -- Periodicals; Heart Failure -- Periodicals; Insuffisance cardiaque -- Périodiques; Heart failure; Periodicals; 616.129005
• DOI: 10.1002/ejhf.1952
• Languages: English
• ISSNs: 1388-9842

Abstract

Abstract : Aims: The prevalence and hospitalizations of patients with heart failure (HF) aged <55 years have increased in Sweden during the last decades. We aimed to compare characteristics of younger and older patients with HF, and examine survival in patients <55 years compared with matched controls. Methods and results: All patients ≥18 years in the Swedish Heart Failure Register from 2003 to 2014 were included. Data were merged with National Patient and Cause of Death Registers. Among 60 962 patients, 3752 (6.2%) were <55 years, and were compared with 7425 controls from the Population Register. Compared with patients ≥55 years, patients <55 years more frequently had registered diagnoses of obesity, dilated cardiomyopathy, congenital heart disease, and an ejection fraction <40% (9.8% vs. 4.7%, 27.2% vs. 5.5%, 3.7% vs. 0.8%, 67.9% vs. 45.1%, respectively; all P < 0.001). One‐year all‐cause mortality was 21.2%, 4.2%, and 0.3% in patients ≥55 years, patients <55 years, and controls <55 years, respectively (all P < 0.001). Patients <55 years had a five times higher mortality risk compared with controls [hazard ratio (HR) 5.48, 95% confidence interval (CI) 4.45–6.74]; the highest HR was in patients 18–34 years (HR 38.3, 95% CI 8.70–169; both P < 0.001). At the age of 20, the estimated life‐years lost was up to 36 years for 50% of patients, with declining estimates with increasing age. Conclusion: Patients with HF <55 years had different comorbidities than patients ≥55 years. The highest mortality risk relative to that of controls was among the youngest patients.