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Higher New York Heart Association classes and increased mortality and hospitalization in patients with heart failure

Ali Ahmed1, Wilbert S Aronow, Jerome L Fleg

  • 1Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Alabama, Birmingham, AL, USA. aahmed@uab.edu

American Heart Journal
|January 31, 2006
PubMed

Insights

Higher New York Heart Association (NYHA) functional classes indicate worse outcomes in heart failure patients with preserved systolic function. This study found increased mortality and hospitalization risks associated with higher NYHA classes.

Area of Science:

  • Cardiology
  • Heart Failure Research
  • Clinical Outcomes

Background:

  • The prognostic significance of New York Heart Association (NYHA) functional class in heart failure with preserved systolic function (HFpEF) remains unclear.
  • Understanding these associations is crucial for risk stratification and management.

Purpose of the Study:

  • To investigate the relationship between NYHA functional class and clinical outcomes in patients with HFpEF.
  • To determine if higher NYHA classes predict increased mortality and hospitalization rates.

Main Methods:

  • A retrospective analysis of 988 patients with ejection fraction > 45% from the DIG trial.
  • Cox proportional hazard models were used to assess risks for all-cause mortality, heart failure mortality, and hospitalizations.
  • Median follow-up was 38.5 months.

Main Results:

  • Patients with higher NYHA classes (II, III, IV) showed significantly increased adjusted hazard ratios for all-cause mortality compared to NYHA class I.
  • NYHA classes II, III, and IV were also associated with significantly higher rates of hospitalization due to worsening heart failure.
  • A clear trend of poorer outcomes with increasing NYHA class was observed (P < .001 for trend).

Conclusions:

  • Higher NYHA functional classes are significantly associated with adverse outcomes, including mortality and hospitalization, in patients with heart failure and preserved systolic function.
  • NYHA class is a valuable prognostic indicator in this patient population.
Abstract

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