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Young patients with heart failure: clinical characteristics and outcomes. Data from the Swedish Heart Failure, National Patient, Population and Cause of Death Registers
Author(s) -
Basic Carmen,
Rosengren Annika,
Alehagen Urban,
Dahlström Ulf,
Edner Magnus,
Fu Michael,
Novak Masuma,
Zverkova Sandström Tatiana,
Schaufelberger Maria
Publication year - 2020
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1002/ejhf.1952
Subject(s) - medicine , heart failure , hazard ratio , ejection fraction , confidence interval , population , cause of death , dilated cardiomyopathy , pediatrics , cardiology , disease , environmental health
Aims The prevalence and hospitalizations of patients with heart failure (HF) aged <55 years have increased in Sweden during the last decades. We aimed to compare characteristics of younger and older patients with HF, and examine survival in patients <55 years compared with matched controls. Methods and results All patients ≥18 years in the Swedish Heart Failure Register from 2003 to 2014 were included. Data were merged with National Patient and Cause of Death Registers. Among 60 962 patients, 3752 (6.2%) were <55 years, and were compared with 7425 controls from the Population Register. Compared with patients ≥55 years, patients <55 years more frequently had registered diagnoses of obesity, dilated cardiomyopathy, congenital heart disease, and an ejection fraction <40% (9.8% vs. 4.7%, 27.2% vs. 5.5%, 3.7% vs. 0.8%, 67.9% vs. 45.1%, respectively; all P < 0.001). One‐year all‐cause mortality was 21.2%, 4.2%, and 0.3% in patients ≥55 years, patients <55 years, and controls <55 years, respectively (all P < 0.001). Patients <55 years had a five times higher mortality risk compared with controls [hazard ratio (HR) 5.48, 95% confidence interval (CI) 4.45–6.74]; the highest HR was in patients 18–34 years (HR 38.3, 95% CI 8.70–169; both P < 0.001). At the age of 20, the estimated life‐years lost was up to 36 years for 50% of patients, with declining estimates with increasing age. Conclusion Patients with HF <55 years had different comorbidities than patients ≥55 years. The highest mortality risk relative to that of controls was among the youngest patients.