Survival associated with two sets of diagnostic criteria for congestive heart failure

Gina D. Schellenbaum, Thomas D. Rea, Susan R. Heckbert, Nicholas L. Smith, Thomas Lumley, Veronique L. Roger, Dalane W. Kitzman, Herman A. Taylor, Daniel Levy, Bruce M. Psaty

Research output: Contribution to journalArticlepeer-review

62 Scopus citations


Congestive heart failure (CHF) definitions vary across epidemiologic studies. The Framingham Heart Study criteria include CHF signs and symptoms assessed by a physician panel. In the Cardiovascular Health Study, a committee of physicians adjudicated CHF diagnoses, confirmed by signs, symptoms, clinical tests, and/or medical therapy. The authors used data from the Cardiovascular Health Study, a population-based cohort study of 5,888 elderly US adults, to compare CHF incidence and survival patterns following onset of CHF as defined by Framingham and/or Cardiovascular Health Study criteria. They constructed an inception cohort of nonfatal, hospitalized CHF patients. Of 875 participants who had qualifying CHF hospitalizations between 1989 and 2000, 54% experienced a first CHF event that fulfilled both sets of diagnostic criteria (concordant), 31% fulfilled only the Framingham criteria (Framingham only), and 15% fulfilled only the Cardiovascular Health Study criteria (Cardiovascular Health Study only). No significant survival difference was found between the Framingham-only group (hazard ratio = 0.87, 95% confidence interval: 0.71, 1.07) or the Cardiovascular Health Study-only group (hazard ratio = 0.89, 95% confidence interval: 0.68, 1.15) and the concordant group (referent). Compared with Cardiovascular Health Study central adjudication, Framingham criteria for CHF identified a larger group of participants with incident CHF, but all-cause mortality rates were similar across these diagnostic classifications.

Original languageEnglish (US)
Pages (from-to)628-635
Number of pages8
JournalAmerican journal of epidemiology
Issue number7
StatePublished - Oct 1 2004


  • Congestive
  • Follow-up studies
  • Heart failure
  • Prognosis
  • Survival

ASJC Scopus subject areas

  • General Medicine


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