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Published on: April 17, 2021
Ischemic Evaluation and Long-Term Mortality in New-Onset Heart Failure Across Various Age-Groups
Alan Manivannan1, Morten Schou2, William E Boden3
1Section of Internal Medicine, Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA.
International Journal of Heart Failure
|August 8, 2026
Summary
Ischemic evaluation in new-onset heart failure patients showed minimal impact on long-term mortality. This finding was consistent across most age groups and notably in the very elderly.
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.
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