Title | Survival associated with two sets of diagnostic criteria for congestive heart failure. |
Publication Type | Journal Article |
Year of Publication | 2004 |
Authors | Schellenbaum, GD, Rea, TD, Heckbert, SR, Smith, NL, Lumley, T, Roger, VL, Kitzman, DW, Taylor, HA, Levy, D, Psaty, BM |
Journal | Am J Epidemiol |
Volume | 160 |
Issue | 7 |
Pagination | 628-35 |
Date Published | 2004 Oct 01 |
ISSN | 0002-9262 |
Keywords | Aged, Aged, 80 and over, Cohort Studies, Diagnosis, Differential, Female, Follow-Up Studies, Heart Failure, Humans, Incidence, Male, Prognosis, Severity of Illness Index, Survival Analysis |
Abstract | <p>Congestive heart failure (CHF) definitions vary across epidemiologic studies. The Framingham Heart Study criteria include CHF signs and symptoms assessed by a physician panel. In the Cardiovascular Health Study, a committee of physicians adjudicated CHF diagnoses, confirmed by signs, symptoms, clinical tests, and/or medical therapy. The authors used data from the Cardiovascular Health Study, a population-based cohort study of 5,888 elderly US adults, to compare CHF incidence and survival patterns following onset of CHF as defined by Framingham and/or Cardiovascular Health Study criteria. They constructed an inception cohort of nonfatal, hospitalized CHF patients. Of 875 participants who had qualifying CHF hospitalizations between 1989 and 2000, 54% experienced a first CHF event that fulfilled both sets of diagnostic criteria (concordant), 31% fulfilled only the Framingham criteria (Framingham only), and 15% fulfilled only the Cardiovascular Health Study criteria (Cardiovascular Health Study only). No significant survival difference was found between the Framingham-only group (hazard ratio = 0.87, 95% confidence interval: 0.71, 1.07) or the Cardiovascular Health Study-only group (hazard ratio = 0.89, 95% confidence interval: 0.68, 1.15) and the concordant group (referent). Compared with Cardiovascular Health Study central adjudication, Framingham criteria for CHF identified a larger group of participants with incident CHF, but all-cause mortality rates were similar across these diagnostic classifications.</p> |
DOI | 10.1093/aje/kwh268 |
Alternate Journal | Am J Epidemiol |
PubMed ID | 15383406 |
Grant List | 1-T32-HL07902 / HL / NHLBI NIH HHS / United States AG09556 / AG / NIA NIH HHS / United States HL43201 / HL / NHLBI NIH HHS / United States N01-HC-85079-86 / HC / NHLBI NIH HHS / United States RC-HL15103 / RC / CCR NIH HHS / United States RC-HL35129 / RC / CCR NIH HHS / United States |