Prevalence and profile of "seasonal frequent flyers" with chronic heart disease: analysis of 1598 patients and 4588 patient-years follow-up

Loader, J. et al. (2019) Prevalence and profile of "seasonal frequent flyers" with chronic heart disease: analysis of 1598 patients and 4588 patient-years follow-up. International Journal of Cardiology, 279, pp. 126-132. (doi:10.1016/j.ijcard.2018.12.060) (PMID:30638747)

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Abstract

Background: Peaks and troughs in cardiovascular events correlated with seasonal change is well established from an epidemiological perspective but not a clinical one. Methods: Retrospective analysis of the recruitment, baseline characteristics and outcomes during minimum 12-month exposure to all four seasons in 1598 disease-management trial patients hospitalised with chronic heart disease. Seasonality was prospectively defined as ≥4 hospitalisations (all-cause) AND >45% of related bed-days occurring in any one season during median 988 (IQR 653, 1394) days follow-up. Results: Patients (39% female) were aged 70 ± 12 years and had a combination of coronary artery disease (58%), heart failure (54%), atrial fibrillation (50%) and multimorbidity. Overall, 29.9% of patients displayed a pattern of seasonality. Independent correlates of seasonality were female gender (adjusted OR 1.27, 95% CI 1.01–1.61; p = 0.042), mild cognitive impairment (adjusted OR 1.51, 95% CI 1.16–1.97; p = 0.002), greater multimorbidity (OR 1.20, 95% CI 1.15–1.26 per Charlson Comorbidity Index Score; p < 0.001), higher systolic (OR 1.01, 95%CI 1.00–1.01 per 1 mmHg; p = 0.002) and lower diastolic (OR 0.99, 95% CI 0.98–1.00 per 1 mmHg; p = 0.002) blood pressure. These patients were more than two-fold more likely to die (adjusted HR 2.16, 95% CI 1.60–2.90; p < 0.001) with the highest and lowest number of deaths occurring during spring (31.7%) and summer (19.9%), respectively. Conclusions: Despite high quality care and regardless of their diagnosis, we identified a significant proportion of “seasonal frequent flyers” with concurrent poor survival in this real-world cohort of patients with chronic heart disease.

Item Type:Articles
Additional Information:This work was funded by a National Health and Medical Research Council of Australia Program of Research Grant (APP 1055214).
Keywords:Atrial fibrillation, cardiovascular disease, cardiovascular seasonality, coronary artery disease, heart failure.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Jhund, Dr Pardeep and McMurray, Professor John and Petrie, Professor Mark
Authors: Loader, J., Chan, Y.-K., A Hawley, J., Moholdt, T., McDonald, C. F., Jhund, P., Petrie, M. C., McMurray, J. J., Scuffham, P. A., Ramchand, J., Burrell, L. M., and Stewart, S.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:International Journal of Cardiology
Publisher:Elsevier
ISSN:0167-5273
ISSN (Online):1874-1754
Published Online:02 January 2019

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