European Heart Journal Advance Access originally published online on December 24, 2008
European Heart Journal 2009 30(6):671-678; doi:10.1093/eurheartj/ehn541
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Survival trends in men and women with heart failure of ischaemic and non-ischaemic origin: data for the period 1987–2003 from the Swedish Hospital Discharge Registry
Department of Emergency and Cardiovascular Medicine, Sahlgrenska Academy, Sahlgrenska University Hospital/Östra, University of Gothenburg, S-416 85 Göteborg, Sweden
Received 11 June 2008; revised 13 November 2008; accepted 18 November 2008; online publish-ahead-of-print 24 December 2008.
* Corresponding author. Tel: +46 31 3434273, Fax: +46 31258933, Email: maria.schaufelberger{at}gu.se
Aims: To investigate gender-specific trends in long-term mortality in patients hospitalized for heart failure (HF).
Methods and results: The Swedish hospital discharge and cause-specific death registers were used to calculate age- and gender-specific trends for long-term prognosis in patients hospitalized with a principal diagnosis of HF from 1987 to 2003. Mortality decreased, mainly during 1987–95, with no further decrease after 2001. Survival in men improved more than in women (P-value for interaction 0.0003), particularly among patients aged <65 years (P-value for interaction: age, gender, and year of hospitalization 0.0003) and more for patients with ischaemic when compared with non-ischaemic HF (P-value for interaction <0.0001). Among men <65 years, the hazard ratio (HR) of dying within 3 years after discharge was 0.40 (95% confidence interval 0.36–0.45) during 1999–2001 when compared with 1987–89. The corresponding HR for women was 0.58 (0.48–0.69). For those discharged during 1999–2001, almost 20% of the patients aged 35–64 years and 40% of those aged 65–84 years died within 3 years.
Conclusion: Long-term mortality in HF in Sweden decreased more for men than for women and more for ischaemic than non-ischaemic HF. There was no further decrease after 2001. Long-term mortality after a first hospitalization remained high.
Key Words: Heart failure • Mortality • Gender • Ischaemic • Non-ischaemic
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