Heart failure (HF) is a disease where the heart is unable to sufficiently pump blood to maintain proper blood flow in the body. A potential cause of HF could be myocardial infarction (MI), caused by the blockage of the blood vessels supplying blood to the heart itself. MI and HF are closely related health problems which force a serious burden on both the patient and the society. Components of health care systems, length of hospital admissions, number of comorbidities and medication use could be related to HF hospitalisation or death. Therefore, this study wants to 1) compare HF care and death between several European countries and, 2) see how MI and HF interplay in a modern era with advanced technology in different health care systems. In this study we hope to give an overview of the status of HF and MI care as well as potential differences in patient outlook in several European countries. Furthermore, we want to highlight differences that could be associated with medication use and death. We hope to create insight in the burden of HF and MI based on real-world evidence.
Objectives
The main objectives of this study are to assess:
a. The comparison of mortality between several European countries
b. The comparison of HF treatment between several European countries
c. The interplay between MI and HF in a modern era with advanced technology in different health care systems
d. To create mappings for linked CPRD, HES and ONS data to the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM) in order to enable the comparison between the different datasets.
Methods and data analysis
We will investigate a longitudinal cohort of HF patients aged 18 years or older between 1st January 1997 and 31st July 2017. Multiple imputation will be used to impute missing variables. We will descriptively assess the baseline characteristics, treatment uptake and incidence of HF. Patients will be followed over time to estimate relative risk of mortality and treatment uptake. Cox proportional hazard models will be used to estimate crude and case-mix standardized mortality.
We will compare our analyses undertaken in linked CPRD, HES and ONS data on common morbidity and mortality outcomes following diagnosis of HF and post-MI HF in the UK by replicating this in Sweden, the Netherlands and Spain using their respective registries.
Temporal trends in heart failure/post myocardial infarction heart failure incidence and care across countries
Influence of heart failure/post myocardial infarction heart failure care on mortality across countries
Compare crude and case-mix adjusted mortality across countries
Temporal trends for mortality
Folkert Asselbergs - Chief Investigator - University College London ( UCL )
Alicia Uijl - Corresponding Applicant - Utrecht University
Arno W Hoes - Collaborator - Maastricht University
Chris Gale - Collaborator - University of Leeds
Harry Hemingway - Collaborator - University College London ( UCL )
Ilonca Vaartjes - Collaborator - University Medical Centre Utrecht
Marinel Cavelaars - Collaborator - Utrecht University
Sheng-Chia Chung - Collaborator - University College London ( UCL )
Spiros Denaxas - Collaborator - University College London ( UCL )
Stefan Koudstaal - Collaborator - University College London ( UCL )
Tatendashe Dondo - Collaborator - University of Leeds
Vaclav Papez - Collaborator - University College London ( UCL )
HES Admitted Patient Care;ONS Death Registration Data;Patient Level Index of Multiple Deprivation