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    Heart failure in younger patients: the Meta-analysis Global Group in Chronic Heart Failure (MAGGIC)

    Wong, Chih M.; Hawkins, Nathaniel M.; Petrie, Mark C.; Jhund, Pardeep S.; Gardner, Roy S.; Ariti, Cono A.; Poppe, K.K.; Earle, Nikki; Whalley, Gillian; Squire, I.B.; Doughty, Robert N.; McMurray, John J.V.

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    Wong. C.M. (2014).pdf (494.1Kb)
    Date
    2014-06-17
    Citation:
    Wong, C.M., Hawkins, N.M., Petrie, M.C., Jhund, P.S., Gardner, R.S., Ariti, C.A., Poppe, K.K., Earle, N., Whalley, G.A., Squire, I.B., Doughty, R.N., McMurray, J.J.V., and on behalf of the MAGGIC Investigators. (2014). Heart failure in younger patients: the Meta-analysis Global Group in Chronic Heart Failure (MAGGIC). European Heart Journal, 35, pp.2714-2721. NOTE: Available from link below.
    Permanent link to Research Bank record:
    https://hdl.handle.net/10652/3020
    Abstract
    Aim Our understanding of heart failure in younger patients is limited. The Meta-analysis Global Group inChronic Heart Failure (MAGGIC) database, which consisted of 24 prospective observational studies and 7 randomized trials, was used to investigate the clinical characteristics, treatment, and outcomes of younger patients. Methods and Results Patients were stratified into six age categories: ,40 (n ¼ 876), 40 – 49 (n ¼ 2638), 50 – 59 (n ¼ 6894), 60 – 69 (n ¼ 12 071), 70 – 79 (n ¼ 13 368), and ≥80 years (n ¼ 6079). Of 41 926 patients, 2.1, 8.4, and 24.8% were younger than 40, 50, and 60 years of age, respectively. Comparing young (,40 years) against elderly (≥80 years), younger patients were more likely to be male (71 vs. 48%) and have idiopathic cardiomyopathy (63 vs. 7%). Younger patients reported better New York Heart Association functional class despite more severe left ventricular dysfunction (median ejection fraction: 31 vs. 42%, all P , 0.0001). Comorbidities such as hypertension, myocardial infarction, and atrial fibrillation were much less common in the young. Younger patients received more disease-modifying pharmacological therapy than their older counterparts. Across the younger age groups (,40, 40 – 49, and 50 – 59 years), mortality rates were low: 1 year 6.7, 6.6, and 7.5%, respectively; 2 year 11.7, 11.5, 13.0%; and 3 years 16.5, 16.2, 18.2%. Furthermore, 1-, 2-, and 3-year mortality rates increased sharply beyond 60 years and were greatest in the elderly (≥80 years): 28.2, 44.5, and 57.2%, respectively. Conclusion Younger patients with heart failure have different clinical characteristics including different aetiologies, more severe left ventricular dysfunction, and less severe symptoms. Three-year mortality rates are lower for all age groups under 60 years compared with older patients.
    Keywords:
    heat failure, younger paitients, meta-analysis
    ANZSRC Field of Research:
    110201 Cardiology (incl. Cardiovascular Diseases)
    Copyright Holder:
    Oxford University Press and the authors

    Copyright Notice:
    All rights reserved
    Available Online at:
    http://eurheartj.oxfordjournals.org/content/ehj/early/2014/06/17/eurheartj.ehu216.full.pdf
    Rights:
    This digital work is protected by copyright. It may be consulted by you, provided you comply with the provisions of the Act and the following conditions of use. These documents or images may be used for research or private study purposes. Whether they can be used for any other purpose depends upon the Copyright Notice above. You will recognise the author's and publishers rights and give due acknowledgement where appropriate.
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