Survival trends in men and women with heart failure of ischaemic and non-ischaemic origin: data for the period 1987-2003 from the Swedish Hospital Discharge Registry

AIMS: To investigate gender-specific trends in long-term mortality in patients hospitalized for heart failure (HF). METHODS AND RESULTS: The Swedish hospital discharge and cause-specific death registers were used to calculate age- and gender-specific trends for long-term prognosis in patients hospitalized with a principal diagnosis of HF from 1987 to 2003. Mortality decreased, mainly during 1987-95, with no further decrease after 2001. Survival in men improved more than in women (P-value for interaction 0.0003), particularly among patients aged <65 years (P-value for interaction: age, gender, and year of hospitalization 0.0003) and more for patients with ischaemic when compared with non-ischaemic HF (P-value for interaction <0.0001). Among men <65 years, the hazard ratio (HR) of dying within 3 years after discharge was 0.40 (95% confidence interval 0.36-0.45) during 1999-2001 when compared with 1987-89. The corresponding HR for women was 0.58 (0.48-0.69). For those discharged during 1999-2001, almost 20% of the patients aged 35-64 years and 40% of those aged 65-84 years died within 3 years. CONCLUSION: Long-term mortality in HF in Sweden decreased more for men than for women and more for ischaemic than non-ischaemic HF. There was no further decrease after 2001. Long-term mortality after a first hospitalization remained high.