Prognosis

• mild heart failure has an annual mortality of not more than 10%
• severe heart failure has an annual mortality of 50%
• B-type natriuretic peptide (BNP):
  • higher concentrations of BNP or its precursor form, N-terminal pro-brain natriuretic peptide, are consistently associated with increased risk of death and cardiovascular events (1)
• a study of over 5 million people examined long-term trends in first hospitalization for heart failure and subsequent survival between 1986 and 2003 (2)
  • age-adjusted first hospitalization rates for heart failure (HF) (per 100 000; 95% CI in parentheses)
    • rose from 124 (119 to 129) in 1986 to 162 (157 to 168) in 1994 and then fell to 105 (101 to 109) in 2003 in men;
    • in women, they rose from 128 (123 to 132) in 1986 to 160 (155 to 165) in 1993, falling to 101 (97 to 105) in 2003
  • case-fatality rates fell steadily over the period
    • adjusted 30-day case-fatality rates fell after discharge (adjusted odds [2003 versus 1986] 0.59 [95% CI 0.45 to 0.63] in men and 0.77 [95% CI 0.67 to 0.88] in women)
    • adjusted 1- and 5-year survival improved similarly
      • median survival increased from 1.33 to 2.34 years in men and from 1.32 to 1.79 years in women.

Reference:

• 1) Doust JA et al. How well des B-type natriuretic peptide predict death and cardiac events in patients with heart failure: systematic review. BMJ 2005;330:625
• 2) Jhund PS et al. Long-term trends in first hospitalization for heart failure and subsequent survival between 1986 and 2003: a population study of 5.1 million people. Circulation. 2009 Feb 3;119(4):515-23.