Prognostic implications of heart failure stages among Chinese community populations: insight from a nationwide...

Area of Science:

• Cardiology
• Public Health
• Epidemiology

Background:

• High burden of heart failure (HF) in China necessitates studies on prognostic implications of HF stages.
• Understanding HF stage-specific mortality risk is crucial for Chinese community populations.

Purpose of the Study:

• To evaluate the association between heart failure (HF) stages and mortality risk.
• To assess the prognostic value of HF staging in a nationwide Chinese cohort.

Main Methods:

• Nationwide enrollment of 23,284 adults aged ≥35 years (2012-2016).
• Classification of participants into HF stages A, B, C, and an apparently-healthy group based on international guidelines.
• Multivariable-adjusted Cox proportional regression analysis to assess associations between HF stages and all-cause, cardiovascular (CV), and non-CV death.

Main Results:

• Advancing HF stages (A, B, C) were significantly associated with increased risks of all-cause, CV, and non-CV mortality compared to the apparently-healthy group.
• Hazard ratios for all-cause death increased progressively with HF stage: Stage A (1.90), Stage B (2.43), and Stage C (6.40).
• Heart failure stages A, B, and C accounted for a substantial population attributable fraction of deaths in China in 2018.

Conclusions:

• Progressive stages of heart failure are linked to escalating mortality risks.
• Urgent development and implementation of early screening and targeted interventions are needed to reduce the public health burden of HF in China.