More ‘malignant’ than cancer? Five‐year survival following a first admission for heart failure

Stewart, Simon; MacIntyre, Kate; Hole, David; Capewell, Simon; McMurray, John J.V.

doi:10.1016/s1388-9842(00)00141-0

Cited by 921 publications

(572 citation statements)

References 27 publications

Supporting

Mentioning

513

Contrasting

Unclassified

Order By: Relevance

“…5, A previous comparative analysis of patients with a first admission to Scottish hospitals in the UK in 1991 with HF and the four most common types of cancer specific to men and women, suggested that, with the exception of lung and ovarian cancer, HF had a similar or worse fiveyear survival rate than the remaining cancers. 9 A comparable analysis of over 1.1 million hospital admissions in Sweden from 1998-2004 reported similar findings. 5 Important limitations of these findings include the observation that a first hospital admission for many cancers frequently relates to elective surgery or investigations 5 , whilst that for HF often represents an acute heart failure syndrome.…”

Section: Introductionmentioning

confidence: 69%

Do patients have worse outcomes in heart failure than in cancer? A primary care‐based cohort study with 10‐year follow‐up in Scotland

Mamas

Sperrin

Watson

et al. 2017

European J of Heart Fail

228

152

View full text Add to dashboard Cite

Aims: To evaluate whether the survival rates of patients with heart failure (HF) in the community are better than those with a diagnosis of the 4 most common cancers in men and women in a contemporary primary care cohort in Scotland. Methods and Results:The data were obtained from the Primary Care Clinical Informatics Unit from a database of 1.75 million people registered with 393 general practices in Scotland. Sex-specific survival modeling was undertaken using Cox proportional hazards models, adjusted for potential confounders. A total of 56,658 patients were eligible to be included in the study with 147,938 person years follow up (median follow up 2.04 years). In men, heart failure (reference group; 5yrs survival 37.7%) had worse mortality outcomes than patients with prostate cancer (HR 0.61, 95%CI 0.57-0.65; 5yrs survival 49.0%), and bladder cancer (HR 0.88, 95%CI 0.81-0.96; 5yrs survival 36.5%), but better than lung cancer (HR 3.86, 95%CI 3.65-4.07; 5yrs survival 2.8%) and colorectal cancer (HR 1.23 95%CI 1.16-1.31; 5 yrs survival 25.9%). In women, patients with HF (reference group; 5yrs survival 31.9%) had worse mortality outcomes than patients with breast cancer (HR 0.55 95%CI 0.51-0.59; 5yrs survival 61.0%), but better outcomes than lung cancer (HR 3.82, 95%CI 3.60-4.05; 5yrs survival 3.6%), ovarian cancer (HR 1.98, 95%CI 1.80-2.17; 5yrs survival 19%) and colorectal cancer (HR 1.21, 95%CI 1.13-1.29; 5yrs survival 28.4%). Conclusions:Despite advances in management, heart failure remains as 'malignant' as some of the common cancers in both men and women.3

show abstract

Section: Introductionmentioning

confidence: 69%

Do patients have worse outcomes in heart failure than in cancer? A primary care‐based cohort study with 10‐year follow‐up in Scotland

Mamas

Sperrin

Watson

et al. 2017

European J of Heart Fail

228

152

View full text Add to dashboard Cite

show abstract

“…Besides its increasing incidence, its poor prognosis is another concern. Although there is an increasing number of treatment options for cardiovascular diseases and in particular for heart failure patients, the prognosis for this disease remains more severe than for malignancies [1][2][3][4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Serum level of apelin-13 negatively correlated with NT-proBNP in heart failure patients

Goidescu

Anton

Leucuţa

et al. 2016

Revista Romana De Medicina De Laborator

View full text Add to dashboard Cite

Background: Apelin is a potent endogenous inotropic peptide with a major role in counteracting the aldosterone and angiotensin II and their negative effects on the cardiovascular system. The exact role of apelin in the pathophysiology of this disease is not well understood. We aimed to investigate the possible associations of apelin-13with clinical and paraclinical characteristics in HF patients as well as studying its dynamics during the course of the heart failure. Method: We performed a prospective observational cohort single-center study. We compared the baseline serum levels of apelin-13 and NT-proBNP level in 53 heart failure patients (acute heart failure, chronic compensated heart failure and chronic decompensated heart failure). We divided the patients according to the apelin-13 level: above and below the median, and we analyzed the relationship between serum apelin-13 and the clinical, echocardiographic, electrocardiographic and biological parameters. Twenty patients were followed-up (after an average time interval of 9 months), investigating the same parameters. Results: The median of apelin-13 was 495pg/mL . We found strong, negative correlation between the serum levels of apelin-13 and p<0.001). For the reassessed patients the median apelin level was significantly higher at follow-up (460 pg/mL, IQR 342-871 pg/mL) as compared with the baseline level (395 pg/mL, IQR 270-603 pg/mL), p=0.019, and maintained the negative correlation with p<0.001

show abstract

“…Heart failure is a chronic medical condition with a very poor prognosis (39). Hence, there is an imperative need for a greater diagnostic accuracy.…”

Section: Discussionmentioning

confidence: 99%

Nonheart failure-associated elevation of amino terminal pro-brain natriuretic peptide in the setting of sepsis

Bar

Swiggum

Straatman

et al. 2006

Canadian Journal of Cardiology

View full text Add to dashboard Cite

O ne-half of a century has been spent debating the etiology of depressed myocardial function in septic shock (1). Brain natriuretic peptide (BNP) is a new biomarker for cardiac dysfunction, and most data in the literature associate its increased levels with depressed myocardial function (2-5). However, increased levels of BNP have also been found in critical illnesses associated with shock (eg, sepsis), apparently not related to myocardial dysfunction. In human myocardium, BNP is secreted in response to myocardial stretch. Its release promotes natriuresis and diuresis, and it has a vasodilatory effect on systemic circulation (6). As such, it reduces preload, venous return and filling pressures with a subsequent reduction in cardiac output (7). The measured BNP increases in response to increases in left ventricular (LV) end-diastolic pressure, pulmonary artery wedge pressure, atrial pressure and LV hypertrophy (8). BNP level is also associated with echocardiographic dysfunction and clinical outcomes (9). The degree of cardiac dysfunction determines the magnitude of increase in BNP level (10).The BNP gene contains an encoded protein consisting of 108 peptides, called pro-BNP (11). The cleavage of pro-BNP within the heart results in two components produced in equal amounts: BNP 32 (the active hormone) and N-terminal (NT) pro-BNP (the inactive fragment) (12). The plasma half-life of NT pro-BNP is approximately 2 h in comparison with that of BNP 32 (20 min) (13), which explains the higher level of NT pro-BNP in myocardial dysfunction (14).In addition to the documented relationship between BNP and myocardial dysfunction mentioned above, there are other conditions associated with increased BNP level that include primary pulmonary hypertension, myocarditis, cardiac allograft rejection, arrhythmogenic right ventricle with decreased LV ejection fraction (EF), renal failure, Kawasaki disease, ascitic cirrhosis and endocrine diseases (Cushing's syndrome, primary hyperaldosteronism) (8). Other patient characteristics that may influence the BNP level, independent of disease, are advancing age, probably reflecting LV subclinical abnormalities (15) and female sex, both of which result in increased BNP level (15,16). Two additional studies have confirmed the correlation of NT pro-BNP with age, but not with sex (17,18). In contrast, obesity is associated with decreased levels of BNP, probably as a result of increased clearance through a receptor contained in adipose tissue (19).Parker et al (20) demonstrated that myocardial depression is also present in human septic shock and is associated with ventricular dilation and decreased LVEF (20). We present two cases of septic shock with markedly increased levels of NT pro-BNP with no evidence of myocardial dysfunction based on evaluation using echocardiography and catheterization. Also described are possible explanations of elevated NT pro-BNP in a setting not related to myocardial dysfunction. Thus, there are situations where the predictive value of BNP is not correlated with the magn...

show abstract

More ‘malignant’ than cancer? Five‐year survival following a first admission for heart failure

Cited by 921 publications

References 27 publications

Do patients have worse outcomes in heart failure than in cancer? A primary care‐based cohort study with 10‐year follow‐up in Scotland

Do patients have worse outcomes in heart failure than in cancer? A primary care‐based cohort study with 10‐year follow‐up in Scotland

Serum level of apelin-13 negatively correlated with NT-proBNP in heart failure patients

Nonheart failure-associated elevation of amino terminal pro-brain natriuretic peptide in the setting of sepsis

Contact Info

Product

Resources

About