Trends in long-term cardiovascular mortality and morbidity in men and women with heart failure of ischemic versus non-ischemic aetiology in Western Australia between 1990 and 2005

Tiew Hwa Katherine Teng, Joseph Hung, Matthew Knuiman, Simon Stewart, Leonard Arnolda, Ian Jacobs, Michael Hobbs, Frank Sanfilippo, Elizabeth Geelhoed, Judith Finn

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Background: It is uncertain if improvements in long-term cardiovascular (CV) mortality have occurred in both men and women with ischemic and non-ischemic forms of heart failure (HF). Methods: The Western Australia Hospital Morbidity Database was used to identify all index (first-ever) hospitalizations for HF between 1990 and 2005. Patients were followed until death attributed to cardiovascular causes or censored on December 31, 2006 to determine 5-year survival. Cox proportional hazards models were used to compare the adjusted mortality hazard ratio (HR) during the study follow-up (4-year periods). Results: A total of 21,507 patients (mean age 73.9 years, 49.1% women) were identified. Women were significantly older than men, and less likely to have ischemic HF (38.8% versus 46.1%). Over the period, age-standardized incidence of first HF hospitalization declined but with the least decline in women with non-ischemic HF (- 13.3%) compared to other subgroups. Risk-adjusted 5-year CV mortality declined over the study period, with HR 0.64 (95% CI 0.60-0.68) for patients admitted in 1998-2001 compared to 1990-1993, with significant improvement in both forms of HF, and in both sexes and across age groups. However, overall total HF hospitalizations increased (+ 26.7%) over the period, particularly for non-ischemic HF (+ 43.7%), of which elderly women formed the predominant group. Conclusions: Risk-adjusted long-term survival improved similarly in men and women, including the elderly, with ischemic and non-ischemic forms of HF during 1990-2005 in Western Australia. However, there was a growing burden of HF hospitalizations particularly for HF of non-ischemic aetiology.

Original languageEnglish
Pages (from-to)405-410
Number of pages6
JournalInternational Journal of Cardiology
Issue number3
Publication statusPublished - 26 Jul 2012
Externally publishedYes



  • Gender
  • Heart failure
  • Hospitalization
  • Survival

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