1. Epidemiology of heart failure and trends in diagnostic work-up: a retrospective, population-based cohort study in Sweden
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Lindmark K, Boman K, Olofsson M, Törnblom M, Levine A, Castelo-Branco A, Schlienger R, Bruce Wirta S, Stålhammar J, and Wikström G
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diagnosis ,heart failure ,incidence ,mortality ,prevalence ,Sweden ,Infectious and parasitic diseases ,RC109-216 - Abstract
Krister Lindmark,1 Kurt Boman,2 Mona Olofsson,2 Michael Törnblom,3 Aaron Levine,3 Anna Castelo-Branco,3 Raymond Schlienger,4 Sara Bruce Wirta,5 Jan Stålhammar,6 Gerhard Wikström7 1Department of Public Health and Clinical Medicine and Heart Centre, Umeå University Hospital, Umeå, Sweden; 2Research Unit, Medicine-Geriatric, Skellefteå County Hospital, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden; 3Real-World & Analytics Solutions, IQVIA, Solna, Sweden; 4Quantitative Safety & Epidemiology, Novartis Pharma AG, Basel, Switzerland; 5Global RWE Cardio-Metabolics, Novartis Sweden AB, Stockholm, Sweden; 6Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden; 7Department for Medical Sciences, Uppsala University, Uppsala, Sweden Purpose: The purpose of this study was to examine the trends in heart failure (HF) epidemiology and diagnostic work-up in Sweden.Methods: Adults with incident HF (≥2 ICD-10 diagnostic codes) were identified from linked national health registers (cohort 1, 2005–2013) and electronic medical records (cohort 2, 2010–2015; primary/secondary care patients from Uppsala and Västerbotten). Trends in annual HF incidence rate and prevalence, risk of all-cause and cardiovascular disease (CVD)-related 1-year mortality and use of diagnostic tests 6 months before and after first HF diagnosis (cohort 2) were assessed.Results: Baseline demographic and clinical characteristics were similar for cohort 1 (N=174,537) and 2 (N=8,702), with mean ages of 77.4 and 76.6 years, respectively; almost 30% of patients were aged ≥85 years. From 2010 to 2014, age-adjusted annual incidence rate of HF/1,000 inhabitants decreased (from 3.20 to 2.91, cohort 1; from 4.34 to 3.33, cohort 2), while age-adjusted prevalence increased (from 1.61% to 1.72% and from 2.15% to 2.18%, respectively). Age-adjusted 1-year all-cause and CVD-related mortality was higher in men than in women among patients in cohort 1 (all-cause mortality hazard ratio [HR] men vs women 1.07 [95% CI 1.06–1.09] and CVD-related mortality subdistribution HR for men vs women 1.04 [95% CI 1.02–1.07], respectively). While 83.5% of patients underwent N-terminal pro-B-type natriuretic peptide testing, only 36.4% of patients had an echocardiogram at the time of diagnosis, although this increased overtime. In the national prevalent HF population (patients with a diagnosis in 1997–2004 who survived into the analysis period; N=273,999), death from ischemic heart disease and myocardial infarction declined between 2005 and 2013, while death from HF and atrial fibrillation/flutter increased (P
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- 2019