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The impact of time to heart failure diagnosis on outcomes in patients tailored for heart failure treatment by use of natriuretic peptides. Results from the UPSTEP study
County Hospital Ryhov, Sweden.
Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping. Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences.ORCID iD: 0000-0001-7431-2873
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.ORCID iD: 0000-0001-6353-8041
Umeå University, Sweden.
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2017 (English)In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 236, 315-320 p.Article in journal (Refereed) Published
Abstract [en]

Background: Heart failure (HF) is a life-threatening condition and optimal handling is necessary to reduce risk of therapy failure. The impact of the duration of HF diagnosis on HF outcome has not previously been examined. The objectives of this study were (I) to evaluate the impact of patient age on clinical outcomes, (II) to evaluate the impact of duration of the HF disease on outcomes, and (III) to evaluate the impact of age and HF duration on B-type Natriuretic Peptide (BNP) concentration in a population of HF patients. Methods and results: In the UPSTEP (Use of PeptideS in Tailoring hEart failure Project) study we retrospectively evaluated how age and HF duration affected HF outcome. HF duration was divided into amp;lt; 1 year, 1-5 years and amp;gt; 5 years. A multivariate Cox proportional hazard regression analysis showed that HF duration influenced outcome more than age, even when adjusted for comorbidities(amp;lt; 1 year versus amp;gt; 5 years: HR 1.65; 95% CI 1.28-2.14; P amp;lt; 0.0002) on HF mortality and hospitalisations. The influence of age on BNP showed increased BNP as age increased. However, there was a significant effect on BNP concentration when comparing HF duration of less than one year to HF duration to more than five years, even when adjusted for age. Conclusions: Patients with longer HF duration had significantly worse outcome compared to those with short HF duration, even when adjusted for patient age and comorbidities. Age did not influence outcome but had an impact on BNP concentration; however, BNP concentration increased as HF duration increased. (C) 2017 Elsevier B.V. All rights reserved.

Place, publisher, year, edition, pages
ELSEVIER IRELAND LTD , 2017. Vol. 236, 315-320 p.
Keyword [en]
Heart failure; B-type Natriuretic Peptides; Age; Heart failure duration; Heart failure outcome
National Category
Family Medicine
Identifiers
URN: urn:nbn:se:liu:diva-138904DOI: 10.1016/j.ijcard.2017.02.054ISI: 000402476500055PubMedID: 28268084OAI: oai:DiVA.org:liu-138904DiVA: diva2:1115888
Note

Funding Agencies|Regional Research Foundation in south-eastern Sweden [FORSS-3963, FORSS-5677, FORSS-F2004-223]; Regional Research Foundation in northern Sweden [33/2006, 20/2007]; Swedish Heart-Lung Foundation [2000596]; Biosite International and Infiniti Medical AB

Available from: 2017-06-27 Created: 2017-06-27 Last updated: 2017-06-27

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Johansson, PeterDahlström, UlfAlehagen, Urban
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Department of Cardiology in LinköpingDepartment of Medical and Health SciencesFaculty of Medicine and Health SciencesDivision of Cardiovascular Medicine
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CiteExportLink to record
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