Prevalence of early stages of heart failure in an elderly risk population: the Copenhagen Heart Failure Risk Study

Aims To describe the prevalence of heart failure (HF) stages in elderly outpatients with risk factors for HF but without known HF, and characterise the clinical, biochemical and echocardiographic findings in each stage.Background Early stages of HF are underdiagnosed; nevertheless, they are associat...

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Main Authors: Lars Køber, Morten Schou, Kasper Karmark Iversen, Freja Stoltze Gaborit, Caroline Kistorp, Thomas Kümler, Christian Hassager, Niels Tønder, Pernille Mørk Hansen, Pia Rørbæk Kamstrup, Jens Faber
Format: Article
Language:English
Published: BMJ Publishing Group 2019-05-01
Series:Open Heart
Online Access:https://openheart.bmj.com/content/6/1/e000840.full
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author Lars Køber
Morten Schou
Kasper Karmark Iversen
Freja Stoltze Gaborit
Caroline Kistorp
Thomas Kümler
Christian Hassager
Niels Tønder
Pernille Mørk Hansen
Pia Rørbæk Kamstrup
Jens Faber
author_facet Lars Køber
Morten Schou
Kasper Karmark Iversen
Freja Stoltze Gaborit
Caroline Kistorp
Thomas Kümler
Christian Hassager
Niels Tønder
Pernille Mørk Hansen
Pia Rørbæk Kamstrup
Jens Faber
author_sort Lars Køber
collection DOAJ
description Aims To describe the prevalence of heart failure (HF) stages in elderly outpatients with risk factors for HF but without known HF, and characterise the clinical, biochemical and echocardiographic findings in each stage.Background Early stages of HF are underdiagnosed; nevertheless, they are associated with an increased risk of hospitalisation and increased mortality. The prevalence of HF stages in elderly high-risk patients is unknown.Methods A total of 400 patients were consecutively included: ≥60 years old, ≥1 risk factor for HF (diabetes, chronic kidney disease, cardiovascular disease, atrial fibrillation, hypertension), and without known or suspected HF. HF stages were defined as the following: stage A (risk factor for HF, normal echocardiography), stage B (abnormal echocardiography, without symptoms of HF) and stage C (abnormal echocardiography, symptoms of HF, clinical signs/increased plasma aminoterminal pro-B-type natriuretic peptide [NT-proBNP] concentrations).Results After thorough examination 44.25% of patients were categorised as HF stage A, 37.5% were HF stage B and 18.25% HF stage C. Those with higher stages of HF were older (p<0.001) and more often had atrial fibrillation (p=0.006). The median plasma NT-proBNP concentrations (pg/mL) were 132.5 for HF stage A, 275.5 for HF stage B and 400.0 for HF stage C (p<0.001). Detectable plasma troponin-I was more frequent with abnormal echocardiography: HF stage A 9.7%, HF stage B 27.3% and HF stage C 30.1% (p<0.001). HF stage C reported higher score on the Minnesota Living with Heart Failure Questionnaire (p<0.001).Conclusions In an elderly high-risk population without known or suspected HF, more than half were HF stage B or C. Higher stages of HF had increased plasma concentrations of NT-proBNP and troponin-I, besides a reduced quality of life. Focus on symptoms and signs of HF in this population are warranted.
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spelling doaj-art-16531fd6668b4654b71db80d18a3e84e2025-08-20T02:14:54ZengBMJ Publishing GroupOpen Heart2053-36242019-05-016110.1136/openhrt-2018-000840Prevalence of early stages of heart failure in an elderly risk population: the Copenhagen Heart Failure Risk StudyLars Køber0Morten Schou1Kasper Karmark Iversen2Freja Stoltze Gaborit3Caroline Kistorp4Thomas Kümler5Christian Hassager6Niels Tønder7Pernille Mørk Hansen8Pia Rørbæk Kamstrup9Jens Faber10Department of Cardiology, University Hospital Copenhagen - Rigshospitalet, Copenhagen, Denmark8 Department of Cardiology, Herlev Hospital, University of Copenhagen, Copenhagen, DenmarkDepartment of Cardiology, Copenhagen University Hospital—Herlev and Gentofte, Herlev, Denmark1 Department of Cardiology, Herlev and Gentofte University Hospital, Herlev, Denmark3 Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark1 Department of Cardiology, Herlev and Gentofte University Hospital, Herlev, DenmarkDepartment of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark6 Department of Internal Medicine KNEA, North Zealand University Hospital, Hillerod, Denmark7 Department of Nephrology, Herlev and Gentofte University Hospital, Herlev, Denmark8 Department of Clinical Chemistry, Herlev and Gentofte University Hospital, Herlev, Denmark3 Department of Clinical Medicine, University of Copenhagen, Copenhagen, DenmarkAims To describe the prevalence of heart failure (HF) stages in elderly outpatients with risk factors for HF but without known HF, and characterise the clinical, biochemical and echocardiographic findings in each stage.Background Early stages of HF are underdiagnosed; nevertheless, they are associated with an increased risk of hospitalisation and increased mortality. The prevalence of HF stages in elderly high-risk patients is unknown.Methods A total of 400 patients were consecutively included: ≥60 years old, ≥1 risk factor for HF (diabetes, chronic kidney disease, cardiovascular disease, atrial fibrillation, hypertension), and without known or suspected HF. HF stages were defined as the following: stage A (risk factor for HF, normal echocardiography), stage B (abnormal echocardiography, without symptoms of HF) and stage C (abnormal echocardiography, symptoms of HF, clinical signs/increased plasma aminoterminal pro-B-type natriuretic peptide [NT-proBNP] concentrations).Results After thorough examination 44.25% of patients were categorised as HF stage A, 37.5% were HF stage B and 18.25% HF stage C. Those with higher stages of HF were older (p<0.001) and more often had atrial fibrillation (p=0.006). The median plasma NT-proBNP concentrations (pg/mL) were 132.5 for HF stage A, 275.5 for HF stage B and 400.0 for HF stage C (p<0.001). Detectable plasma troponin-I was more frequent with abnormal echocardiography: HF stage A 9.7%, HF stage B 27.3% and HF stage C 30.1% (p<0.001). HF stage C reported higher score on the Minnesota Living with Heart Failure Questionnaire (p<0.001).Conclusions In an elderly high-risk population without known or suspected HF, more than half were HF stage B or C. Higher stages of HF had increased plasma concentrations of NT-proBNP and troponin-I, besides a reduced quality of life. Focus on symptoms and signs of HF in this population are warranted.https://openheart.bmj.com/content/6/1/e000840.full
spellingShingle Lars Køber
Morten Schou
Kasper Karmark Iversen
Freja Stoltze Gaborit
Caroline Kistorp
Thomas Kümler
Christian Hassager
Niels Tønder
Pernille Mørk Hansen
Pia Rørbæk Kamstrup
Jens Faber
Prevalence of early stages of heart failure in an elderly risk population: the Copenhagen Heart Failure Risk Study
Open Heart
title Prevalence of early stages of heart failure in an elderly risk population: the Copenhagen Heart Failure Risk Study
title_full Prevalence of early stages of heart failure in an elderly risk population: the Copenhagen Heart Failure Risk Study
title_fullStr Prevalence of early stages of heart failure in an elderly risk population: the Copenhagen Heart Failure Risk Study
title_full_unstemmed Prevalence of early stages of heart failure in an elderly risk population: the Copenhagen Heart Failure Risk Study
title_short Prevalence of early stages of heart failure in an elderly risk population: the Copenhagen Heart Failure Risk Study
title_sort prevalence of early stages of heart failure in an elderly risk population the copenhagen heart failure risk study
url https://openheart.bmj.com/content/6/1/e000840.full
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