Key result
In a Norwegian nationwide registry, the annual incidence of heart failure decreased from 2.80 to 2.21 per 1000 from 2011 to 2016, while prevalence increased and 5-year all-cause mortality was 33.8%.
Cohort (n=55,669)
Yes
In a nationwide Norwegian registry from 2011-2016, heart failure incidence decreased while prevalence increased, with a 5-year all-cause mortality of 33.8%.
Warrants caution against practice changes from registry trends alone; leaves open drivers of incidence decline and mortality reduction.
Background and purpose: The aim of this study was to calculate the incidence, prevalence and survival of heart failure (HF) in Norway in 2011–2016. Methods: Using the nationwide Norwegian Prescription Database (NorPD) which includes all prescription drugs dispensed by pharmacies in Norway, we identified all patients ≥18 years of age with at least two dispensations associated with HF (defined by ICD-10 codes I50, I11, I13 or I42) during 2011–2016. The individual index date was set to the date of the first HF dispensation in the study period. Patients were followed until death, 5 years or end of follow-up 31.10.2017. Annual incidence and prevalence were estimated using a look-back period to March 1, 2008. However, ICD-10 codes were not fully implemented until March 2009. Comorbidities were identified as ICD-10 codes. Survival was calculated using Kaplan-Meier survival curves. Results: A total of 84 268 unique patients with an ICD-10 code of HF for the first time were identified between 2011 and 2016. Of these, 55 669 fulfilled the inclusion criteria of ≥2 HF prescriptions. The median age was 72 years and 60% were men. Women were older than men when first diagnosed with HF (median age 76 yrs vs 70 yrs). The most common comorbidities were hypertension (74%), coronary artery disease (49%) and atrial fibrillation (32%). The overall annual incidence of HF decreased over the 6-year period from 2.80 to 2.21 per 1000, and the prevalence increased from 1.20% to 1.71% (table). Both incidence and prevalence rates were higher in men than in women. All-cause mortality after 1, 3 and 5 years was 8.8%, 22.1% and 33.8%, respectively. Survival decreased with increasing age (figure) and were lower in men than in women. In patients 75–84 years, 5-year survival was 60% in women, 51.7% in men. Mortality rates were probably underestimated since some patients died before the second dispensation of drugs and were not included in the study.
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Halvorsen et al. (2018) conducted a cohort in Heart failure (n=55,669). Heart failure was evaluated on Incidence, prevalence, and survival. In a Norwegian nationwide registry, the annual incidence of heart failure decreased from 2.80 to 2.21 per 1000 from 2011 to 2016, while prevalence increased and 5-year all-cause mortality was 33.8%.
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