Ischemic Evaluation and Long-Term Mortality in New-Onset Heart Failure Across Various Age-Groups

Area of Science:

• Cardiology
• Clinical Medicine
• Public Health

Background:

• The prognostic value of ischemic evaluation in new-onset heart failure is unclear, potentially varying by age and sex.
• Real-world data is needed to understand long-term mortality risks associated with ischemic evaluation in heart failure patients.

Purpose of the Study:

• To analyze the association between ischemic evaluation and long-term mortality in patients newly diagnosed with heart failure.
• To investigate potential differences in this association based on patient age and sex.

Main Methods:

• A cohort of 61,475 new-onset heart failure patients diagnosed between 2008-2018 was identified from the Danish National patient registry.
• Patients without prior ischemic evaluation, known coronary artery disease, or acute myocardial infarction were included.
• Inverse probability weighted Cox regression models were used to analyze the association of ischemic evaluation within 90 days of diagnosis with long-term mortality.

Main Results:

• Ischemic evaluation was performed in 20% of patients (12,503).
• During a mean follow-up of 4.6 years, 37% of patients died.
• Ischemic evaluation was associated with a reduced hazard ratio for death (0.92; 95% CI, 0.90-0.95).
• This association was stronger in males (0.87) than females (0.98) and varied by age group, showing benefit in middle-aged to older adults but not the very elderly (>85 years).

Conclusions:

• Ischemic evaluation showed marginal to no improvement in long-term mortality for many new-onset heart failure patients.
• The benefit was less pronounced in females and the very elderly population.
• Further research may be needed to refine risk stratification and management strategies for these patients.