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

Abstract

Abstract Background: The prognostic impact of heart failure relative to that of ‘high‐profile’ disease states such as cancer, within the whole population, is unknown. Methods: All patients with a first admission to any Scottish hospital in 1991 for heart failure, myocardial infarction or the four most common types of cancer specific to men and women were identified. Five‐year survival rates and associated loss of expected life‐years were then compared. Results: In 1991, 16224 men had an initial hospitalisation for heart failure ( n ‐ 3241), myocardial infarction ( n ‐ 6932) or cancer of the lung, large bowel, prostate or bladder ( n ‐ 6051). Similarly, 14842 women were admitted for heart failure ( n ‐ 3606), myocardial infarction ( n ‐ 4916), or cancer of the breast, lung, large bowel or ovary ( n ‐ 6320). With the exception of lung cancer, heart failure was associated with the poorest 5‐year survival rate (approximately 25% for both sexes). On an adjusted basis, heart failure was associated with worse long‐term survival than bowel cancer in men (adjusted odds ratio, 0.89; 95% CI, 0.82–0.97; P < 0.01) and breast cancer in women (odds ratio, 0.59; 95% CI, 0.55–0.64; P < 0.001). The overall population rate of expected life‐years lost due to heart failure in men was 6.7 years/1000 and for women 5.1 years/1000. Conclusion: With the notable exception of lung cancer, heart failure is as ‘malignant’ as many common types of cancer and is associated with a comparable number of expected life‐years lost.

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Affiliated Institutions

• University of Glasgow GB

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