© 2001 European Society of Cardiology
More ‘malignant’ than cancer? Five-year survival following a first admission for heart failure
a Clinical Research Initiative in Heart Failure, University of Glasgow Glasgow G12 8QQ, UK
b Department of Public Health, University of Glasgow Glasgow G12 8QQ, UK
c West of Scotland Cancer Surveillance Unit, University of Glasgow Glasgow G12 8QQ, UK
* Corresponding author. Tel.: +44-141-330-6588; fax: +44-141-330-6588 E-mail address: jmcmurray{at}bio.gla.ac.uk (J.J. McMurray).
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Abstract |
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Background: The prognostic impact of heart failure relative to that of ‘high-profile’ disease states such as cancer, within the whole population, is unknown.
Methods: All patients with a first admission to any Scottish hospital in 1991 for heart failure, myocardial infarction or the four most common types of cancer specific to men and women were identified. Five-year survival rates and associated loss of expected life-years were then compared.
Results: In 1991, 16224 men had an initial hospitalisation for heart failure (n = 3241), myocardial infarction (n = 6932) or cancer of the lung, large bowel, prostate or bladder (n = 6051). Similarly, 14842 women were admitted for heart failure (n = 3606), myocardial infarction (n = 4916), or cancer of the breast, lung, large bowel or ovary (n = 6320). With the exception of lung cancer, heart failure was associated with the poorest 5-year survival rate (approximately 25% for both sexes). On an adjusted basis, heart failure was associated with worse long-term survival than bowel cancer in men (adjusted odds ratio, 0.89; 95% CI, 0.82–0.97; P < 0.01) and breast cancer in women (odds ratio, 0.59; 95% CI, 0.55–0.64; P < 0.001). The overall population rate of expected life-years lost due to heart failure in men was 6.7 years/1000 and for women 5.1 years/1000.
Conclusion: With the notable exception of lung cancer, heart failure is as ‘malignant’ as many common types of cancer and is associated with a comparable number of expected life-years lost.
Key Words: Heart failure • Cancer • Prognosis • Population • Epidemiology • Survival
Received September 19, 2000; Revised October 27, 2000; Accepted October 31, 2000
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S. Stewart and J. D. Horowitz Detecting early clinical deterioration in chronic heart failure patients post-acute hospitalisation--a critical component of multidisciplinary, home-based intervention? Eur J Heart Fail, June 1, 2002; 4(3): 345 - 351. [Abstract] [Full Text] [PDF]
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S. Stewart, A. Jenkins, S. Buchan, A. McGuire, S. Capewell, and J. J.J.V. McMurray The current cost of heart failure to the National Health Service in the UK Eur J Heart Fail, June 1, 2002; 4(3): 361 - 371. [Abstract] [Full Text] [PDF]
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J. McMurray and M. A. Pfeffer New Therapeutic Options in Congestive Heart Failure: Part I Circulation, April 30, 2002; 105(17): 2099 - 2106. [Full Text] [PDF]
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J.J.V McMurray and S Stewart The burden of heart failure Eur. Heart J. Suppl., April 1, 2002; 4(suppl_D): D50 - D58. [Abstract] [PDF]
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P Menasche and M Desnos Cardiac reparation: fixing the heart with cells, new vessels and genes Eur. Heart J. Suppl., April 1, 2002; 4(suppl_D): D73 - D81. [Abstract] [PDF]
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L. Blue, E. Lang, J. J V McMurray, A. P Davie, T. A McDonagh, D. R Murdoch, M. C Petrie, E. Connolly, J. Norrie, C. E Round, et al. Randomised controlled trial of specialist nurse intervention in heart failure BMJ, September 29, 2001; 323(7315): 715 - 718. [Abstract] [Full Text] [PDF]
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