Cardiovascular Diseases Clinical Trial
To examine temporal trends from 1995 and 2000 in the incidence rates of heart failure, its therapeutic management, and changes over time in the hospital and long-term survival of patients with heart failure.
BACKGROUND:
Heart failure is estimated to contribute to nearly 1 million hospitalizations and
approximately 250,000 deaths annually in the U.S. The number of new cases of heart failure
in the U.S. is estimated to exceed 400,000 annually. Though reliable estimates of the
magnitude, incidence, and mortality of heart failure remain sorely lacking, heart failure is
associated with a grim prognosis. However, little recent data exist, particularly from a
community-wide perspective, to determine whether the incidence or survival associated with
heart failure, and the management of this clinical syndrome, has changed over time.
DESIGN NARRATIVE:
The study uses residents of the Worcester (MA) metropolitan area (1990 census 437,000) and
examines changes over time in these and additional outcomes for patients with validated
heart failure during 1995 and 2000. Complimenting the hospital surveillance of heart
failure, newly diagnosed cases of heart failure occurring in members of the largest HMO in
Central Massachusetts during 1995 and 2000 will be identified and monitored over time. To
accomplish the study objectives, the medical records of residents of the Worcester
metropolitan area hospitalized with a discharge diagnosis of heart failure and related
diagnostic rubrics will be individually reviewed and validated according to pre-established
diagnostic criteria. The use of traditional criteria for heart failure as well as
development of new criteria for the epidemiological study of heart failure will be an
important focus of this observational study. Records for additional hospitalizations and
death certificates will be reviewed to examine trends in long-term survival of discharged
hospital patients through the year 2005.
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