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Effect of 2022 ACC/AHA/HFSA Criteria on Stages of Heart Failure in a Pooled Community Cohort.
Saturday,2023-06-17 14:17 America/Los_Angeles — ecterry
| Title | Effect of 2022 ACC/AHA/HFSA Criteria on Stages of Heart Failure in a Pooled Community Cohort. |
| Publication Type | Journal Article |
| Year of Publication | 2023 |
| Authors | Mohebi, R, Wang, D, Lau, ES, Parekh, JK, Allen, N, Psaty, BM, Benjamin, EJ, Levy, D, Wang, TJ, Shah, SJ, Gottdiener, JS, Januzzi, JL, Ho, JE |
| Journal | J Am Coll Cardiol |
| Volume | 81 |
| Issue | 23 |
| Pagination | 2231-2242 |
| Date Published | 2023 Jun 13 |
| ISSN | 1558-3597 |
| Keywords | American Heart Association, Atherosclerosis, Cardiology, Female, Heart Failure, Humans, Longitudinal Studies, Prognosis, United States |
| Abstract | <p><b>BACKGROUND: </b>The 2022 American College of Cardiology (ACC)/American Heart Association (AHA)/Heart Failure Society of America (HFSA) clinical practice guideline proposed an updated definition for heart failure (HF) stages.</p><p><b>OBJECTIVES: </b>This study aimed to compare prevalence and prognosis of HF stages according to classification/definition originally described in 2013 and 2022 ACC/AHA/HFSA definitions.</p><p><b>METHODS: </b>Study participants from 3 longitudinal cohorts (the MESA [Multi-Ethnic Study of Atherosclerosis], CHS [Cardiovascular Health Study], and the FHS [Framingham Heart Study]), were categorized into 4 HF stages according to the 2013 and 2022 criteria. Cox proportional hazards regression was used to assess predictors of progression to symptomatic HF and adverse clinical outcomes associated with each HF stage.</p><p><b>RESULTS: </b>Among 11,618 study participants, according to the 2022 staging, 1,943 (16.7%) were healthy, 4,348 (37.4%) were in stage A (at risk), 5,019 (43.2%) were in stage B (pre-HF), and 308 (2.7%) were in stage C/D (symptomatic HF). Compared to the classification/definition originally described in 2013, the 2022 ACC/AHA/HFSA approach resulted in a higher proportion of individuals with stage B HF (increase from 15.9% to 43.2%); this shift disproportionately involved women as well as Hispanic and Black individuals. Despite the 2022 criteria designating a greater proportion of individuals as stage B, the relative risk of progression to symptomatic HF remained similar (HR: 10.61; 95% CI: 9.00-12.51; P < 0.001).</p><p><b>CONCLUSIONS: </b>New standards for HF staging resulted in a substantial shift of community-based individuals from stage A to stage B. Those with stage B HF in the new system were at high risk for progression to symptomatic HF.</p> |
| DOI | 10.1016/j.jacc.2023.04.007 |
| Alternate Journal | J Am Coll Cardiol |
| PubMed ID | 37286252 |
| Grant List | N01HC25195 / HL / NHLBI NIH HHS / United States HHSN268201500001I / HL / NHLBI NIH HHS / United States HHSN268201200036C / HL / NHLBI NIH HHS / United States HHSN268200800007C / HL / NHLBI NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States N01HC85080 / HL / NHLBI NIH HHS / United States N01HC85081 / HL / NHLBI NIH HHS / United States N01HC85082 / HL / NHLBI NIH HHS / United States N01HC85083 / HL / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States 75N92021D00006 / HL / NHLBI NIH HHS / United States U01 HL130114 / HL / NHLBI NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States HHSN268201500003I / HL / NHLBI NIH HHS / United States N01HC95159 / HL / NHLBI NIH HHS / United States N01HC95160 / HL / NHLBI NIH HHS / United States N01HC95161 / HL / NHLBI NIH HHS / United States N01HC95162 / HL / NHLBI NIH HHS / United States N01HC95163 / HL / NHLBI NIH HHS / United States N01HC95164 / HL / NHLBI NIH HHS / United States N01HC95165 / HL / NHLBI NIH HHS / United States N01HC95166 / HL / NHLBI NIH HHS / United States N01HC95167 / HL / NHLBI NIH HHS / United States N01HC95168 / HL / NHLBI NIH HHS / United States N01HC95169 / HL / NHLBI NIH HHS / United States UL1 TR000040 / TR / NCATS NIH HHS / United States UL1 TR001079 / TR / NCATS NIH HHS / United States UL1 TR001420 / TR / NCATS NIH HHS / United States UL1 TR001881 / TR / NCATS NIH HHS / United States R01 AG023629 / AG / NIA NIH HHS / United States |
ePub date:
23/06