The prognosis of heart failure in the general population. The Rotterdam Study

Mosterd, Arend; Cost, Bernard; Hoes, Arno W.; Bruijne, M.C. de; Deckers, Jaap W.; Hofman, Albert; Grobbee, Diederick E.

doi:10.1053/euhj.2000.2533

Cited by 407 publications

(257 citation statements)

References 41 publications

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“…Two studies have found that high adiponectin levels are associated with increased mortality in heart failure patients [18,19], perhaps because high levels of adiponectin are indicative of systemic wasting in this population [6]. In this regard, low body mass index, which leads to elevated adiponectin levels, is associated with increased mortality following the onset of heart failure, whereas elevated body mass index, which leads to reduced adiponectin levels, increases the risk for developing heart failure [29,30]. Similarly, hypercholesterolemia is predictive of improved survival in heart failure patients presumably because it is a surrogate marker of body mass [31].…”

Section: Discussionmentioning

confidence: 99%

Adiponectin protects against the development of systolic dysfunction following myocardial infarction

Shibata

Izumiya

Sato

et al. 2007

Journal of Molecular and Cellular Cardiology

193

142

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Section: Discussionmentioning

confidence: 99%

Adiponectin protects against the development of systolic dysfunction following myocardial infarction

Shibata

Izumiya

Sato

et al. 2007

Journal of Molecular and Cellular Cardiology

193

142

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“…HF is a complex clinical syndrome and it is the final and most severe manifestation of nearly every form of heart disease (4,5). The prognosis of HF is particularly poor, with fewer than 50% of subjects remaining alive by 5 years, and only 10% by 10 years following the initial diagnosis (14)(15)(16)(17). Likewise, we recently found that HF is an important contributor to the excess overall mortality in RA (Crow- …”

Section: Discussionmentioning

confidence: 99%

How much of the increased incidence of heart failure in rheumatoid arthritis is attributable to traditional cardiovascular risk factors and ischemic heart disease?

Crowson¹,

Nicola²,

Kremers³

et al. 2005

Arthritis & Rheumatism

142

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Objective. To compare the proportion of the risk for the development of heart failure (HF) that is attributable to traditional cardiovascular (CV) risk factors, ischemic heart disease (IHD), and alcohol abuse between subjects with and subjects without rheumatoid arthritis (RA).Methods. A population-based inception cohort of RA patients was assembled along with a similar cohort of subjects without RA. All individuals were followed up through their complete medical records, until HF incidence, death, migration, or January 1, 2001. The attributable risk of HF was estimated as the difference between the observed cumulative incidence of HF in each cohort (estimated from multivariable Cox models and adjusted for the competing risk of death) and the predicted cumulative incidence of HF in the absence of risk factors, with results expressed as a percentage of the observed cumulative incidence.Results. A total of 575 RA subjects and 583 non-RA subjects (mean age 57 years, 73% women) without HF at incidence/index date had a mean followup of 15.1 and 17.0 years, respectively. During that period, 165 RA and 115 non-RA subjects had a first episode of HF, with a cumulative incidence of 36.3% and 20.4%, respectively, at age 80 years. Among non-RA subjects, 77% of the HF at age 80 years was attributable to CV risk factors, IHD, and alcohol abuse combined, whereas among RA subjects, only 54% of the HF at age 80 years was attributable to these factors (P < 0.01). Conclusion. The excess risk of HF among RA patients is not explained by an increased frequency or effect of CV risk factors and IHD.Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease of unknown etiology, affecting ϳ1% of the adult general population (1,2). Patients with RA have twice the risk of heart failure (HF) when compared with individuals of the same age and sex without RA (3). The mechanism behind this increased risk is unknown. The etiology of HF can be multifactorial, with several clinical risk factors coexisting and interacting to produce this clinical syndrome (4,5). Ischemic heart disease (IHD) and hypertension have long been recognized as major risk factors for HF in the general population (6-9). Therefore, elimination of traditional cardiovascular (CV) risk factors and IHD is a recognized approach to prevent HF (9).However, we previously reported that the increased risk of HF in subjects with RA appears to be independent of the presence or effect of IHD and CV risk factors (3). Consequently, IHD and CV risk factors may play a different role with respect to the development and prevention of HF in RA subjects, compared with non-RA subjects. The aim of the present study was to compare the proportion of the risk for the development of HF that is attributable to traditional CV risk factors, IHD, and alcohol abuse between subjects with and subjects without RA.

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“…Despite advances in medical and device therapy for patients with CHF, mortality remains unacceptably high 23 and cardiac transplantation remains the most durable therapy for patients with advanced CHF, with a 10-y survival approaching 50%. 24 Therefore, BAS may be considered as a bridge to transplantation in patients with advanced heart failure who would otherwise not be considered surgical candidates.…”

Section: Clinical Investigations Continuedmentioning

confidence: 99%

Safety and Efficacy of Bariatric Surgery in Morbidly Obese Patients with Severe Systolic Heart Failure

Ramani

McCloskey

Ramanathan

et al. 2008

Clinical Cardiology

104

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Background: Morbid obesity (MO) is a risk factor for congestive heart failure (CHF). The presence of MO impairs functional status and disqualifies patients for cardiac transplantation. Bariatric surgery (BAS) is a frontline, durable treatment for MO; however, the safety and efficacy of BAS in advanced CHF is unknown. Hypothesis: We hypothesized that by utilizing a coordinated approach between an experienced surgical team and heart failure specialists, BAS is safe in patients with advanced systolic CHF and results in favorable outcomes. Methods: We performed a retrospective chart review of 12 patients with MO (body mass index [BMI] 53±7 kg/m 2 ) and systolic CHF (left ventricular ejection fraction [LVEF] 22±7%, New York Heart Association [NYHA] class 2.9±0.7) who underwent BAS, and then compared outcomes with 10 matched controls (BMI 47.2±3.6 kg/m 2 , LVEF 24±7%, and NYHA class 2.4±0.7) who were given diet and exercise counseling. Results: At 1 y, hospital readmission in BAS patients was significantly lower than controls (0.4±0.8 versus 2.5±2.6, p = 0.04); LVEF improved significantly in BAS patients (35±15%, p = 0.005), but not in controls (29±14%, p = not significant [NS]). The NYHA class improved in BAS patients (2.3±0.5, p = 0.02), but deteriorated in controls (3.3±0.9, p = 0.02). One BAS patient was successfully transplanted, and another listed for transplantation. Conclusions: Bariatric surgery is safe and effective in patients with MO and severe systolic CHF, and should be considered in patients who have failed conventional therapy to improve clinical status.

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The prognosis of heart failure in the general population. The Rotterdam Study

Abstract: Heart failure generally afflicts older subjects in the community, carries a poor prognosis, especially in the presence of concomitant diseases, and confers a fivefold increase in the risk of sudden death.

Cited by 407 publications

References 41 publications

Adiponectin protects against the development of systolic dysfunction following myocardial infarction

Adiponectin protects against the development of systolic dysfunction following myocardial infarction

How much of the increased incidence of heart failure in rheumatoid arthritis is attributable to traditional cardiovascular risk factors and ischemic heart disease?

Safety and Efficacy of Bariatric Surgery in Morbidly Obese Patients with Severe Systolic Heart Failure

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