Heart Failure in Young Adults Is Associated With High Mortality: A Contemporary Population-Level Analysis

BACKGROUND: Data on young patients with heart failure (HF) are sparse. We examined the characteristics, health care use, and survival of younger vs older patients with HF.

METHODS: We performed an analysis of linked administrative databases in Alberta, Canada. We identified 34,548 patients who had a first hospitalization for HF as the principal diagnosis from 2002-2014. Patients were stratified into 4 age groups: 20-44, 45-54, 55-64, and ≥ 65 years.

RESULTS: Of the 34,548 patients, 496 (1.4%), 1319 (3.8%), 3359 (9.7%), and 29,374 (85%) were aged 20-44, 45-54, 55-64, and ≥ 65 years, respectively. The incidence of HF hospitalization decreased over time among patients ≥ 65 years and increased among men aged 20-64 years. In the year after the index HF hospitalization, compared with older patients, younger patients were less likely to present to the emergency department (ED) (eg, 67.2% of those aged 20-44 years vs 74.8% of those aged ≥ 65 years) or to be hospitalized for any reason (48.5% vs 61.2%), cardiovascular causes (28.6% vs 34.4%), or HF (14.8% vs 23.6%). Mortality rates were lower in younger patients aged 20-44 years but were still substantial: 3.9%, 12.4%, and 27.7% at 30 days, 1 year, and 5 years, respectively.

CONCLUSIONS: Although young patients, especially those < 45 years of age, accounted for a small proportion of the total population, adverse events were frequent, with half of the younger patients being readmitted, two-thirds presenting to an ED, and > 10% dying within a year.