Hospitalizations for heart failure in the United States--a sign of hope.

摘要

It is important to recognize that among patients discharged following hospital admission for HF, a significant number of rehospitalizations are not related to HF. In the EVEREST (Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study with Tolvaptan) trial8 conducted in patients admitted for worsening HF with reduced ejection fraction, the total rehos-pitalization rate exceeded 50% at 9.9 months, and less than half of rehospitalizations were due to HF.8 This occurred despite the study population being relatively young for HF (mean age, 62years), with fewmajorcomorbid conditions. IntheDIG (Digitalis Investigation Group) ancillary trial9 that studied outpatients with HF and preserved ejection fraction, the total hos-pitalization rate exceeded 65% during a mean follow-up of 37 months. Of these hospitalizations, only 35% were related to HF.8 In both studies, total cardiovascular hospitalizations represented a large proportion of the hospitalizations. Targeting total re-hospitalization rather than rehospitalization for HF rates may be especially important given the aging population and their associated cardiac and noncardiac comorbid conditions.