Facts about Heart Failure in Canada

Cardiovascular Disease and Mortality in Canada

Cardiovascular Disease and Mortality in Canada
Heart and Stroke Foundation of Canada, 2003.

HF Prevalence in Canada

HF Prevalence in Canada MapHF Prevalence in Canada Key

Chow C-M et al. Can J Cardiol 2005;21(14):1265-71.

Majority of HF Patients Treated by GPs/FPs

Majority of HF Patients Treated by GPs/FPs MapMajority of HF Patients Treated by GPs/FPs Key

Tu K et al. Can J Cardiol 2004;20:282-91.

HF Cases on the Rise

Projected number of incident hospitalizations for CHF patients, using high, medium and low population growth projections in Canada 1996-2050

HF Cases on the Rise

Johansen et al. Can J Cardiol 2003;19(4):430-5.

Heart Failure Mortality

  • Canada’s average annual in-hospital mortality rate is:
    • 9.5 deaths/100 hospitalized patients >65 years of age
    • 12.5 deaths/100 hospitalized patients >75 years of age
  • HF patients have a poor prognosis, with an average 1-year mortality rate of 33%

Lee DS et al. Can J Cardiol 2004;20(6):599-607.

HF Readmissions

  • Hospital readmission rates are high, and mainly due to recurrent heart failure
HF Readmissions

Lee DS et al. Can J Cardiol 2004;20(6):599-607

Mortality in HF Increases With Lower LVEF

  • Higher LVEF decreases the risk of death
Mortality in HF Increases With Lower LVEF

Data derived from CHARM patients (n=7599). Solomon SD et al. Circulation 2005;112:3738-44.

HF Hospitalizations Increase With Lower LVEF

  • Higher LVEF decreases the risk of HF hospitalization
HF Hospitalizations Increase With Lower LVEF

Data derived from CHARM patients (n=7599). Solomon SD et al. Circulation 2005;112:3738-44.

Mortality in HF Increases With Worsening NYHA Classification

  • Worse NYHA classification associated with an increased risk of death

P vs Class I HF. Data derived from DIG patients (n=988). Ahmed A et al. Am Heart J 2006;151:444-50.

Hospitalization for HF Increases With Worsening NYHA Classification

  • Worse NYHA classification associated with an increased risk of all-cause hospitalization

Ahmed A et al. Am Heart J 2006;151:444-50.

Treatment of Heart Failure

Treatment of Heart Failure

Arnold JMO et al. Can J Cardiol 2006;22(1):23-45.

What Dosages of Drugs Should Be Used?

Drug Dosages

* The Healing and Early Afterload Reduced Therapy (HEART) trial showed that 10 mg od was effective for attenuating left ventricular remodeling. † Not available in Canada.

Arnold JMO et al. Can J Cardiol 2006;22(1):23-45.

Conclusions

  • Make an accurate and timely diagnosis
  • Initiate treatment to
    • Reduce HF risk factors
    • Reduce HF symptoms
    • Reduce hospitalizations
    • Improve quality of life
    • Prolong survival
  • Refer patients at higher risk to specialist or HF clinic
  • Continue to translate new knowledge into practice
  • Combine available healthcare resources to improve delivery of best care and practices to HF patients
  • Improve HF outcomes in Canada

Number of Hospitalizations for CHF (actual and projected) in Canada 1980-2025

CHF Hospitalizations

Heart and Stroke Foundation of Canada

Number of CHF Deaths (actual and projected) in Canada, 1980-2025

CHF Deaths

Heart and Stroke Foundation of Canada

Heart Failure Costs in the UK

Heart Failure Costs in the UK

Stewart et al. Eur J Heart Fail 2002;4:361-7

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