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The prognostic significance of heart failure with preserved left ventricular ejection fraction: a literature‐based meta‐analysis
Author(s) -
Somaratne Jithendra B.,
Berry Colin,
McMurray John J.V.,
Poppe Katrina K.,
Doughty Robert N.,
Whalley Gillian A.
Publication year - 2009
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 - 10.1093/eurjhf/hfp103
Subject(s) - medicine , heart failure , cardiology , ejection fraction , heart failure with preserved ejection fraction , prospective cohort study , observational study , odds ratio , meta analysis , epidemiology
Aims Heart failure (HF) with normal or preserved left ventricular (LV) ejection fraction (HFPEF) has been reported to be associated with similar outcome as HF with reduced EF (HFREF) in registry‐based and epidemiological analyses, but many of these studies excluded patients who did not have EF measurements. Conversely, prior prospective studies have reported better outcome for patients with HFPEF. We performed a meta‐analysis of prospective observational studies comparing all‐cause mortality in patients with HFREF and HFPEF. Methods and results We searched several online databases for studies comparing outcome in HFREF and HFPEF, published before 2007. Inclusion criteria: prospective, clinical HF, near complete EF data, and mortality outcome. Review Manager version 4.2.3 software was used for the analysis. Overall, 24 501 patients [9299 deaths (38%)] from 17 studies are included. Average follow‐up was 47 months; the HFPEF group was older (69 vs. 66 years) and more likely to be female (44% vs. 26%). Of the 7688 patients with HFPEF 2468 died (32.1%), compared with 6831 of the 16 813 patients with HFREF (40.6%): odds ratio 0.51 (95% CI: 0.48, 0.55). Conclusion This literature‐based meta‐analysis demonstrates that mortality among patients with HFPEF was half that observed in those with HFREF, in contrast to previous reports suggesting that mortality may be similar between both groups.