| アブストラクト | OBJECTIVES: To determine the association between symptoms and signs reported in primary care consultations following a new diagnosis of heart failure (HF), and 3-month hospitalisation and mortality. DESIGN: Nested case-control study with density-based sampling. SETTING: Clinical Practice Research Datalink, linked to hospitalisation and mortality (1998-2020). PARTICIPANTS: Database cohort of 86 882 patients with a new HF diagnosis. In two separate analyses for (1) first hospitalisation and (2) death, we compared the 3-month history of symptoms and signs in cases (patients with HF with the event), with their respective controls (patients with HF without the respective event, matched on diagnosis date (+/-1 month) and follow-up time). Controls could be included more than once and later become a case. MAIN OUTCOME MEASURES: All-cause, HF and non-cardiovascular disease (non-CVD) hospitalisation and mortality. RESULTS: During a median follow-up of 3.22 years (IQR: 0.59-8.18), 56 677 (65%) experienced first hospitalisation and 48 146 (55%) died. These cases were matched to 356 714 and 316 810 HF controls, respectively. For HF hospitalisation, the strongest adjusted associations were for symptoms and signs of fluid overload: pulmonary oedema (adjusted OR 3.08; 95% CI 2.52, 3.64), shortness of breath (2.94; 2.77, 3.11) and peripheral oedema (2.16; 2.00, 2.32). Generic symptoms also showed significant associations: depression (1.50; 1.18, 1.82), anxiety (1.35; 1.06, 1.64) and pain (1.19; 1.10, 1.28). Non-CVD hospitalisation had the strongest associations with chest pain (2.93; 2.77, 3.09), fatigue (1.87; 1.73, 2.01), general pain (1.87; 1.81, 1.93) and depression (1.59; 1.44, 1.74). CONCLUSIONS: In the primary care HF population, routinely recorded cardiac and non-specific symptoms showed differential risk associations with hospitalisation and mortality. |
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| ジャーナル名 | Heart (British Cardiac Society) |
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| 投稿日 | 2023/12/2 |
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| 投稿者 | Ali, Mohammad Rizwan; Lam, Carolyn S P; Stromberg, Anna; Hand, Simon P P; Booth, Sarah; Zaccardi, Francesco; Squire, Iain; McCann, Gerry P; Khunti, Kamlesh; Lawson, Claire Alexandra |
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| 組織名 | Department of Cardiovascular Sciences, University of Leicester, Leicester, UK;mra30@leicester.ac.uk.;NIHR Leicester Cardiovascular Biomedical Research Unit, NIHR Leicester Biomedical;Research Centre, Leicester, UK.;Leicester Real World Evidence Unit, University of Leicester, Leicester, UK.;Department of Cardiology, National Heart Centre Singapore, Singapore.;Medical School, National University of Singapore, Singapore.;Department of Medical and Health Science, Linkopings universitet, Linkoping,;Sweden.;Faculty of Medicine, Linkoping University, Linkoping, Sweden.;Department of Population Health Sciences, University of Leicester, Leicester, UK.;Diabetes Research Centre, University of Leicester, Leicester, UK.;Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.;Cardiovascular Research Unit, NIHR Leicester Biomedical Research Centre,;Leicester, UK.;Leicester Diabetes Centre, University of Leicester, Leicester, UK. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/38040451/ |
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