Facts about Heart Failure in Canada

Cardiovascular Disease and Mortality in Canada

Heart and Stroke Foundation of Canada, 2003.

HF Prevalence in Canada

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

Majority of HF Patients Treated by GPs/FPs

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

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

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

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

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

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

What Dosages of Drugs Should Be Used?

* 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

Heart and Stroke Foundation of Canada

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

Heart and Stroke Foundation of Canada

Heart Failure Costs in the UK

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