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Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
Published on: June 10, 2025
261
Changes in heart failure management and long-term mortality over 10 years: observational study
Alex Bottle1, Roger Newson2, Puji Faitna3
1School of Public Health, Imperial College London, London, UK robert.bottle@imperial.ac.uk.
Open Heart
|March 31, 2022
Summary
Long-term heart failure survival saw modest gains over a decade, with improvements mainly in primary care diagnoses. Guideline compliance saw little change despite national initiatives.
Area of Science:
- Cardiology
- Public Health
- Health Services Research
Background:
- Heart failure (HF) remains a significant public health concern with varying long-term survival rates.
- Understanding trends in patient characteristics, treatment adherence, and outcomes is crucial for improving HF management.
- Previous studies have highlighted disparities in care and outcomes based on diagnosis setting.
Purpose of the Study:
- To compare long-term survival in two heart failure cohorts diagnosed 10 years apart.
- To assess changes in patient demographics, clinical guideline adherence, and survival rates between the cohorts.
- To investigate differences in outcomes based on the setting of heart failure diagnosis (primary care vs. hospital).
Main Methods:
- Analysis of two large cohorts (2001-2002 and 2011-2012) from the Clinical Practice Research Datalink.
- Kaplan-Meier plots used to estimate survival rates post-diagnosis.
- Summary of compliance with national guidelines and changes in medication and diagnostic test utilization.
Main Results:
- Patients diagnosed in 2011-2012 were older with lower blood pressure/cholesterol but more comorbidities.
- Five-year survival rates were similar (40.0% vs. 40.2%), but improvements were noted in primary care diagnoses.
- Use of beta-blockers and renin-angiotensin system blockers increased significantly; echocardiogram and specialist referral rates also rose.
Conclusions:
- Despite a decade of healthcare initiatives, national clinical guideline compliance for heart failure showed only modest improvement from a low baseline.
- Long-term survival gains were observed, but these were more pronounced in patients diagnosed in primary care settings.
- Further efforts are needed to enhance guideline adherence and reduce disparities in heart failure care and outcomes.
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