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    The survival of patients with heart failure with preserved or reduced left ventricular ejection fraction: an individual patient data meta-analysis

    Whalley, Gillian; Doughty, Robert N.

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    MAGGIC Main results EHJ.pdf (197.4Kb)
    Date
    2011
    Citation:
    Berry, C., Doughty, R. N., Granger, C., Køber, L., Massie, B., McAlister, F., ... & Hogg, K. (2011). The survival of patients with heart failure with preserved or reduced left ventricular ejection fraction: an individual patient data meta-analysis. European Heart Journal
    Permanent link to Research Bank record:
    https://hdl.handle.net/10652/2127
    Abstract
    Heart failure is a leading cause of cardiovascular morbidity and mortality and arises as a consequence of many cardiovascular conditions, including coronary artery disease (CAD), valve disease, and hypertension. Heart failure has been traditionally viewed as a failure of contractile function and left ventricular (LV) ejection fraction (EF) has been widely used to define systolic function, assess prognosis, and select patients for therapeutic interventions. However, it is recognized that heart failure can occur in the presence of normal or near-normal EF: so-called ‘heart failure with preserved EF (HF-PEF)’ which accounts for a substantial proportion of clinical cases of heart failure.1 – 4 There are many differences between patients with heart failure with reduced EF (HF-REF) and patients with HF-PEF. The latter are older and more often women, are less likely to have CAD, and more likely to have underlying hypertension.1,2,5 In addition, patients with HF-PEF do not obtain similar clinical benefits from angiotensin-converting enzyme (ACE) inhibition or angiotensin receptor blockade compared with patients with HF-REF.6 – 8 Several comparisons of survival between patients with HF-PEF and those with HF-REF have been reported but have given inconsistent results.1,2 Although a recent literature-based meta-analysis demonstrated that patients with HF-PEF may have lower mortality than those with HF-REF,9 lack of patient-level data precluded careful adjustment for differences between these patient groups in potentially important prognostic variables such as age, gender, co-morbidity, and aetiology of HF. Therefore, we undertook a meta-analysis using individual patient data to examine mortality rates in patients with HF-PEF and HF-REF...
    Keywords:
    heart failure, prognosis, meta-analysis
    ANZSRC Field of Research:
    110201 Cardiology (incl. Cardiovascular Diseases)
    Copyright Holder:
    Published on behalf of the European Society of Cardiology. All rights reserved. & The Author 2011
    Rights:
    This digital work is protected by copyright. It may be consulted by you, provided you comply with the provisions of the Act and the following conditions of use: Any use you make of these documents or images must be for research or private study purposes only, and you may not make them available to any other person. You will recognise the author's and publishers rights and give due acknowledgement where appropriate.
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