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Survival associated with two sets of diagnostic criteria for congestive heart failure.

TitleSurvival associated with two sets of diagnostic criteria for congestive heart failure.
Publication TypeJournal Article
Year of Publication2004
AuthorsSchellenbaum, GD, Rea, TD, Heckbert, SR, Smith, NL, Lumley, T, Roger, VL, Kitzman, DW, Taylor, HA, Levy, D, Psaty, BM
JournalAm J Epidemiol
Date Published2004 Oct 01
KeywordsAged, 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>
Alternate JournalAm J Epidemiol
PubMed ID15383406
Grant List1-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