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Survival associated with two sets of diagnostic criteria for congestive heart failure

Gina D Schellenbaum1, Thomas D Rea, Susan R Heckbert

  • 1Department of Epidemiology, Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA. ginas@u.washington.edu

American Journal of Epidemiology
|September 24, 2004
PubMed

Insights

Congestive heart failure (CHF) definitions vary. This study found similar survival rates for CHF patients identified by Framingham criteria alone, Cardiovascular Health Study criteria alone, or both, indicating comparable mortality across diagnostic groups.

Area of Science:

  • Cardiology
  • Epidemiology
  • Gerontology

Background:

  • Congestive heart failure (CHF) definitions differ across epidemiologic studies.
  • The Framingham Heart Study (FHS) and Cardiovascular Health Study (CHS) use distinct criteria for CHF diagnosis.
  • Varied definitions can impact the understanding of CHF incidence and survival.

Purpose of the Study:

  • To compare CHF incidence and survival patterns using FHS and CHS diagnostic criteria.
  • To analyze survival differences between patients meeting both criteria, only FHS criteria, or only CHS criteria.

Main Methods:

  • Utilized data from the Cardiovascular Health Study, a cohort of 5,888 elderly US adults.
  • Constructed an inception cohort of 875 hospitalized CHF patients between 1989 and 2000.
  • Compared diagnostic classifications: concordant (both criteria), FHS-only, and CHS-only.

Main Results:

  • 54% of CHF events met both FHS and CHS criteria (concordant).
  • 31% met only FHS criteria, and 15% met only CHS criteria.
  • No significant survival differences were observed between FHS-only, CHS-only, and concordant groups.

Conclusions:

  • Framingham criteria identify more incident CHF cases than CHS criteria alone.
  • All-cause mortality rates were similar across different CHF diagnostic classifications.
  • CHF diagnostic criteria variations do not appear to significantly impact survival outcomes in this elderly cohort.

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