Article Impact Level: HIGH Data Quality: STRONG Summary of Journal of the American College of Cardiology, 81(23), 2231–2242. https://doi.org/10.1016/j.jacc.2023.04.007 Dr. Reza Mohebi et al.
Points
- The research paper compared the prevalence and prognosis of heart failure (HF) stages based on the 2013 and 2022 definitions proposed by ACC, AHA, and HFSA.
- Data from three longitudinal cohorts were analyzed, including the MESA, CHS, and FHS studies.
- The updated 2022 HF staging significantly increased the proportion of individuals classified as stage B HF compared to the 2013 classification.
- The shift towards stage B HF disproportionately affected women, Hispanic, and Black individuals.
- Despite the increased number of individuals in stage B HF under the 2022 criteria, the risk of progression to symptomatic HF remained similar.
Summary
This research paper compares the prevalence and prognosis of heart failure (HF) stages based on the 2013 and 2022 definitions proposed by the American College of Cardiology (ACC), American Heart Association (AHA), and Heart Failure Society of America (HFSA). The study utilized data from three longitudinal cohorts: the MESA, CHS, and FHS. Participants were classified into four HF stages according to the 2013 and 2022 criteria. Cox proportional hazards regression was employed to analyze predictors of progression to symptomatic HF and adverse clinical outcomes associated with each stage.
The results of the study, involving 11,618 participants, indicated that according to the 2022 staging, 16.7% were classified as healthy, 37.4% as stage A (at risk), 43.2% as stage B (pre-HF), and 2.7% as stage C/D (symptomatic HF). Compared to the 2013 classification, the updated 2022 ACC/AHA/HFSA approach resulted in a significantly higher proportion of individuals categorized as stage B HF (increased from 15.9% to 43.2%). This shift predominantly affected women, as well as Hispanic and Black individuals. Despite the increased number of individuals classified as stage B HF under the 2022 criteria, the risk of progression to symptomatic HF remained similar.
In conclusion, adopting the new HF staging standards led to a notable transition of community-based individuals from stage A to stage B. Under the updated system, those classified as stage B HF exhibited a high risk of progressing to symptomatic HF. These findings emphasize the importance of the revised HF staging definitions in identifying at-risk individuals and implementing appropriate interventions and monitoring strategies.
Link to the article: https://www.sciencedirect.com/science/article/abs/pii/S0735109723053718
References Mohebi, R., Wang, D., Lau, E. S., Parekh, J. K., Allen, N., Psaty, B. M., Benjamin, E. J., Levy, D., Wang, T. J., Shah, S. J., Gottdiener, J. S., Januzzi, J. L., & Ho, J. E. (2023). Effect of 2022 acc/aha/hfsa criteria on stages of heart failure in a pooled community cohort. Journal of the American College of Cardiology, 81(23), 2231–2242. https://doi.org/10.1016/j.jacc.2023.04.007
