The survival of patients with heart failure with preserved or reduced left ventricular ejection fraction: An individual patient data meta-analysis: Meta-analysis Global Group in Chronic Heart Failure (MAGGIC)

Meta-analysis Global Group in Chronic Heart Failure (MAGGIC)

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Abstract

Aims: A substantial proportion of patients with heart failure have preserved left ventricular ejection fraction (HF-PEF). Previous studies have reportedmixed resultswhether survival is similar to those patientswith heart failure and reduced EF (HF-REF). Methods and results: We compared survival in patients with HF-PEF with that in patients with HF-REF in a meta-analysis using individual patient data. Preserved EF was defined as an EF ≥ 50%. The 31 studies included 41 972 patients: 10 347 with HF-PEF and 31 625 with HF-REF. Compared with patients with HF-REF, those with HF-PEF were older (mean age 71 vs. 66 years), were more often women (50 vs. 28%), and have a history of hypertension (51 vs. 41%). Ischaemic aetiology was less common (43 vs. 59%) in patients with HF-PEF. There were 121 [95% confidence interval (CI): 117, 126] deaths per 1000 patient-years in those with HF-PEF and 141 (95% CI: 138, 144) deaths per 1000 patient-years in those with HF-REF. Patients with HF-PEF had lower mortality than those with HF-REF (adjusted for age, gender, aetiology, and history of hypertension, diabetes, and atrial fibrillation); hazard ratio 0.68 (95% CI: 0.64, 0.71). The risk of death did not increase notably until EF fell below 40%. Conclusion: Patients with HF-PEF have a lower risk of death than patients with HF-REF, and this difference is seen regardless of age, gender, and aetiology of HF. However, absolute mortality is still high in patients with HF-PEF highlighting the need for a treatment to improve prognosis.

Original languageEnglish
Pages (from-to)1750-1757
Number of pages8
JournalEuropean heart journal
Volume33
Issue number14
DOIs
Publication statusPublished - Dec 20 2013

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Stroke Volume
Meta-Analysis
Heart Failure
Survival
Confidence Intervals
Hypertension
Mortality
Atrial Fibrillation

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

The survival of patients with heart failure with preserved or reduced left ventricular ejection fraction : An individual patient data meta-analysis: Meta-analysis Global Group in Chronic Heart Failure (MAGGIC). / Meta-analysis Global Group in Chronic Heart Failure (MAGGIC).

In: European heart journal, Vol. 33, No. 14, 20.12.2013, p. 1750-1757.

Research output: Contribution to journalArticle

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title = "The survival of patients with heart failure with preserved or reduced left ventricular ejection fraction: An individual patient data meta-analysis: Meta-analysis Global Group in Chronic Heart Failure (MAGGIC)",
abstract = "Aims: A substantial proportion of patients with heart failure have preserved left ventricular ejection fraction (HF-PEF). Previous studies have reportedmixed resultswhether survival is similar to those patientswith heart failure and reduced EF (HF-REF). Methods and results: We compared survival in patients with HF-PEF with that in patients with HF-REF in a meta-analysis using individual patient data. Preserved EF was defined as an EF ≥ 50{\%}. The 31 studies included 41 972 patients: 10 347 with HF-PEF and 31 625 with HF-REF. Compared with patients with HF-REF, those with HF-PEF were older (mean age 71 vs. 66 years), were more often women (50 vs. 28{\%}), and have a history of hypertension (51 vs. 41{\%}). Ischaemic aetiology was less common (43 vs. 59{\%}) in patients with HF-PEF. There were 121 [95{\%} confidence interval (CI): 117, 126] deaths per 1000 patient-years in those with HF-PEF and 141 (95{\%} CI: 138, 144) deaths per 1000 patient-years in those with HF-REF. Patients with HF-PEF had lower mortality than those with HF-REF (adjusted for age, gender, aetiology, and history of hypertension, diabetes, and atrial fibrillation); hazard ratio 0.68 (95{\%} CI: 0.64, 0.71). The risk of death did not increase notably until EF fell below 40{\%}. Conclusion: Patients with HF-PEF have a lower risk of death than patients with HF-REF, and this difference is seen regardless of age, gender, and aetiology of HF. However, absolute mortality is still high in patients with HF-PEF highlighting the need for a treatment to improve prognosis.",
author = "{Meta-analysis Global Group in Chronic Heart Failure (MAGGIC)} and Doughty, {Robert Neil} and R. Cubbon and J. Ezekowitz and J. Gonzalez-Juanatey and M. Gorini and I. Gotsman and L. GrigorianShamagian and M. Guazzi and M. Kearney and L. K{\o}ber and M. Komajda and {di Lenarda}, A. and M. Lenzen and D. Lucci and S. Macı´n and B. Madsen and A. Maggioni and M. Martı´nez-Sell{\'e}s and F. McAlister and F. Oliva and K. Poppe and M. Rich and M. Richards and M. Senni and I. Squire and G. Taffet and L. Tarantini and C. Tribouilloy and R. Troughton and H. Tsutsui and Whalley, {G. A.} and N. Earle and K. Perera and K. Poppe and J. Dobson and S. Pocock and B. Andersson and C. Hall and Richards, {A. M.} and J. Lainchbury and C. Berry and K. Hogg and J. Norrie and K. Stevenson and M. Brett and J. McMurray and Pfeffer, {M. A.} and K. Swedberg and Granger, {C. B.} and P. Held",
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T1 - The survival of patients with heart failure with preserved or reduced left ventricular ejection fraction

T2 - An individual patient data meta-analysis: Meta-analysis Global Group in Chronic Heart Failure (MAGGIC)

AU - Meta-analysis Global Group in Chronic Heart Failure (MAGGIC)

AU - Doughty, Robert Neil

AU - Cubbon, R.

AU - Ezekowitz, J.

AU - Gonzalez-Juanatey, J.

AU - Gorini, M.

AU - Gotsman, I.

AU - GrigorianShamagian, L.

AU - Guazzi, M.

AU - Kearney, M.

AU - Køber, L.

AU - Komajda, M.

AU - di Lenarda, A.

AU - Lenzen, M.

AU - Lucci, D.

AU - Macı´n, S.

AU - Madsen, B.

AU - Maggioni, A.

AU - Martı´nez-Sellés, M.

AU - McAlister, F.

AU - Oliva, F.

AU - Poppe, K.

AU - Rich, M.

AU - Richards, M.

AU - Senni, M.

AU - Squire, I.

AU - Taffet, G.

AU - Tarantini, L.

AU - Tribouilloy, C.

AU - Troughton, R.

AU - Tsutsui, H.

AU - Whalley, G. A.

AU - Earle, N.

AU - Perera, K.

AU - Poppe, K.

AU - Dobson, J.

AU - Pocock, S.

AU - Andersson, B.

AU - Hall, C.

AU - Richards, A. M.

AU - Lainchbury, J.

AU - Berry, C.

AU - Hogg, K.

AU - Norrie, J.

AU - Stevenson, K.

AU - Brett, M.

AU - McMurray, J.

AU - Pfeffer, M. A.

AU - Swedberg, K.

AU - Granger, C. B.

AU - Held, P.

PY - 2013/12/20

Y1 - 2013/12/20

N2 - Aims: A substantial proportion of patients with heart failure have preserved left ventricular ejection fraction (HF-PEF). Previous studies have reportedmixed resultswhether survival is similar to those patientswith heart failure and reduced EF (HF-REF). Methods and results: We compared survival in patients with HF-PEF with that in patients with HF-REF in a meta-analysis using individual patient data. Preserved EF was defined as an EF ≥ 50%. The 31 studies included 41 972 patients: 10 347 with HF-PEF and 31 625 with HF-REF. Compared with patients with HF-REF, those with HF-PEF were older (mean age 71 vs. 66 years), were more often women (50 vs. 28%), and have a history of hypertension (51 vs. 41%). Ischaemic aetiology was less common (43 vs. 59%) in patients with HF-PEF. There were 121 [95% confidence interval (CI): 117, 126] deaths per 1000 patient-years in those with HF-PEF and 141 (95% CI: 138, 144) deaths per 1000 patient-years in those with HF-REF. Patients with HF-PEF had lower mortality than those with HF-REF (adjusted for age, gender, aetiology, and history of hypertension, diabetes, and atrial fibrillation); hazard ratio 0.68 (95% CI: 0.64, 0.71). The risk of death did not increase notably until EF fell below 40%. Conclusion: Patients with HF-PEF have a lower risk of death than patients with HF-REF, and this difference is seen regardless of age, gender, and aetiology of HF. However, absolute mortality is still high in patients with HF-PEF highlighting the need for a treatment to improve prognosis.

AB - Aims: A substantial proportion of patients with heart failure have preserved left ventricular ejection fraction (HF-PEF). Previous studies have reportedmixed resultswhether survival is similar to those patientswith heart failure and reduced EF (HF-REF). Methods and results: We compared survival in patients with HF-PEF with that in patients with HF-REF in a meta-analysis using individual patient data. Preserved EF was defined as an EF ≥ 50%. The 31 studies included 41 972 patients: 10 347 with HF-PEF and 31 625 with HF-REF. Compared with patients with HF-REF, those with HF-PEF were older (mean age 71 vs. 66 years), were more often women (50 vs. 28%), and have a history of hypertension (51 vs. 41%). Ischaemic aetiology was less common (43 vs. 59%) in patients with HF-PEF. There were 121 [95% confidence interval (CI): 117, 126] deaths per 1000 patient-years in those with HF-PEF and 141 (95% CI: 138, 144) deaths per 1000 patient-years in those with HF-REF. Patients with HF-PEF had lower mortality than those with HF-REF (adjusted for age, gender, aetiology, and history of hypertension, diabetes, and atrial fibrillation); hazard ratio 0.68 (95% CI: 0.64, 0.71). The risk of death did not increase notably until EF fell below 40%. Conclusion: Patients with HF-PEF have a lower risk of death than patients with HF-REF, and this difference is seen regardless of age, gender, and aetiology of HF. However, absolute mortality is still high in patients with HF-PEF highlighting the need for a treatment to improve prognosis.

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U2 - 10.1093/eurheartj/ehr254

DO - 10.1093/eurheartj/ehr254

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VL - 33

SP - 1750

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JO - European Heart Journal

JF - European Heart Journal

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