Is the prognosis of congestive heart failure patients still so bad?

Authors: O. Ludka;  L. Galková;  M. Šablaturová;  J. Jarkovský;  L. Dušek;  J. Špinar
Published in: Kardiol Rev Int Med 2011, 13(1): 30-36
Category: From Hypertension to Heart Failure


According to a Framingham study, more than half of patients with congestive heart failure die within five years of the occurrence of clinical symptoms, and about 17% of patients within a year of clinical manifestation of the disease.

To determine the mortality rate of patients with CHF monitored in the outpatient heart failure clinic of University Hospital Brno.

Retrospective analysis of data ­obtained from outpatient records of consecutive patients with CHF.

159 patients, 70.4% men, 29.6% women, age 66 (40–84) years, follow up period 32.5 (11.1–61.9) months (8 to 66 months), NYHA class I–II/II/III 26.4/61.6/12%, LV EF 30 (15–45) %, diastolic dysfunction 94.3%, aetiology of CHF – 68.6% ischaemic heart disease, 22.6% dilatative cardiomyopathy, other 8.8%, comorbidities – hypertension 67.9%, myocardial infarction 49.1%, dyslipoproteinaemia 56.6%, diabetes ­mellitus 34%, stroke + TIA 11.3%, COPD 8.8%, anemia 16.4%, atrial fibrilation 15.1%, GF according to Cockroft formula 66.8 (27.2–125.2) ml/s, GF < 60 ml/s 44.7%, pharmacological treatment: ACE-I 84.3%, ARB 13.2%, BB 95.6%, loop diuretics 60.4%, hydrochlorothiazid 21.7%, spironolacton 52.8%, digitalis 22.6%, statins 61.6%, non-pharmacological treatment: pacemaker 18.9%, CRT-D 5%, CRT-P 7.5%, PCI 30.2%, CABG 10.1%.

24 patients (15.1%) died during the monitoring period, 18 (11.3%) of them from non-cardiovascular complications. The cumulative survival rate was 96.2% after first year, 90.8% after the second year, 87.6% after the third year and 82.7% after the fourth year of monitoring.

Mortality in the Framingham study highly exceeds mortality in our sample, which may be explained not only by improvements in both pharmacological and non-pharmacological treatment strategies, but also by slightly different spectra of patients.

chronic heart failure – prognosis – pharmacological treatment – non-pharmacological treatment


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Paediatric cardiology Internal medicine Cardiac surgery Cardiology
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