How do heart failure patients die?

Approximately 90% of heart failure patients die from cardiovascular causes. Fifty per cent die from progressive heart failure, and the remainder die suddenly from arrhythmias and ischaemic events. Autopsy reveals the presence of an acute ischaemic event in approximately 50% of sudden deaths and in 35% of all deaths among patients with ischaemic heart failure. An accurate description of the cause and mode of death is important if we are to elucidate the mechanisms that are operative in the heart failure population. At present, the most accurate data on mode of death are obtained from large randomized heart failure trials. They indicate that current treatment strategies for heart failure prolong life expectancy, but have relatively little impact on the proportion of heart failure patients who die from cardiovascular causes. The ultimate goal of intervention is to shift the balance toward more deaths from non-cardiovascular causes.