Observational studyHeart (British Cardiac Society)2021
Association of heart failure and its comorbidities with loss of life expectancy.
Observational study in Heart (British Cardiac Society), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Self-care behaviour and associated factors among heart failure patients in Ethiopia: a systematic review and meta-analysis.BMJ open · 2023Pooled it
- Relationship between comorbidity and health outcomes in patients with heart failure: a systematic review and meta-analysis.BMC cardiovascular disorders · 2023Pooled it
- Association between the beta-blockers, calcium channel blockers, all-cause mortality and length of hospitalization in patients with heart failure with preserved ejection fraction: A meta-analysis of randomized controlled trials.Clinical cardiology · 2023Pooled it
- Echocardiographic screening for heart failure and optimization of the care pathway for individuals with pacemakers: a randomized controlled trial.Nature medicine · 2024Trial
- Body mass index, waist-to-height ratio, and the risks of early-onset heart failure in adults age under 45.American journal of preventive cardiology · 2026Article
- Cardiovascular-Kidney-Metabolic Syndrome and Life Expectancy in U.S. Adults.JACC. Advances · 2026Article
- Pivotal Trials in Heart Failure in 2024-Putting Evidence into Clinical Practice!The International journal of angiology : official publication of the International College of Angiology, Inc · 2026Review
- Summary measures derived from a multi-state modeling framework to characterize the course of heart disease.BMC medical research methodology · 2026Article
- Cardiorenal and Metabolic Convergence in Acute Heart Failure: Severe Cardiorenometabolic Syndrome as a High-Risk Phenotype.Biomedicines · 2026Article
- Article
- Comorbidity trajectories before and after the diagnosis of heart failure: A UK Biobank cohort study.European journal of heart failure · 2025Article
- Association of albumin-corrected anion gap with mortality in ICU patients with heart failure and acute kidney injury: analysis of the MIMIC-IV database.European journal of medical research · 2025Article
- Widening gap in life expectancy between patients with heart failure living in most and least deprived areas: a longitudinal cohort study.BMC medicine · 2025Article
- Association of triglyceride-glucose index trajectories with the risk of worsening heart failure in elderly patients with chronic heart failure and type 2 diabetes: a competing risk analysis.Cardiovascular diabetology · 2025Article
- A discrete-time split-state framework for multi-state modeling with application to describing the course of heart disease.BMC medical research methodology · 2025Article
- Relationship between albumin-corrected anion gap and short- and medium-term all-cause mortality in heart failure patients with a single ICU admission.Frontiers in cardiovascular medicine · 2025Article
- Comorbidity progression analysis: patient stratification and comorbidity prediction using temporal comorbidity network.Health information science and systems · 2024Article
- Urate-lowering therapy in patients with hyperuricemia and heart failure: A retrospective cohort study using the UK Clinical Practice Research Datalink.Clinical cardiology · 2024Article
- Harmony in Chaos: Deciphering the Influence of Ischemic Cardiomyopathy and Non-Cardiac Comorbidities on Holter ECG Parameters in Chronic Heart Failure Patients: A Pilot Study.Medicina (Kaunas, Lithuania) · 2024Article
- Analysis of the survival time of patients with heart failure with reduced ejection fraction: a Bayesian approach via a competing risk parametric model.BMC cardiovascular disorders · 2024Article
Corrections and comments
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Authors and funding
16 authors.
Funding
Abstract
objectiveEstimating survival can aid care planning, but the use of absolute survival projections can be challenging for patients and clinicians to contextualise. We aimed to define how heart failure and its major comorbidities contribute to loss of actuarially predicted life expectancy.
methodsWe conducted an observational cohort study of 1794 adults with stable chronic heart failure and reduced left ventricular ejection fraction, recruited from cardiology outpatient departments of four UK hospitals. Data from an 11-year maximum (5-year median) follow-up period (999 deaths) were used to define how heart failure and its major comorbidities impact on survival, relative to an age-sex matched control UK population, using a relative survival framework.
resultsAfter 10 years, mortality in the reference control population was 29%. In people with heart failure, this increased by an additional 37% (95% CI 34% to 40%), equating to an additional 2.2 years of lost life or a 2.4-fold (2.2-2.5) excess loss of life. This excess was greater in men than women (2.4 years (2.2-2.7) vs 1.6 years (1.2-2.0); p<0.001). In patients without major comorbidity, men still experienced excess loss of life, while women experienced less and were non-significantly different from the reference population (1 year (0.6-1.5) vs 0.4 years (-0.3 to 1); p<0.001). Accrual of comorbidity was associated with substantial increases in excess lost life, particularly for diabetes, chronic kidney and lung disease.
conclusionsComorbidity accounts for the majority of lost life expectancy in people with heart failure. Women, but not men, without comorbidity experience survival close to reference controls.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.