{
  "abstract": "Background We investigated symptoms reported before and after heart failure (HF) diagnosis and their associations with 3-month hospitalisation and mortality.Objectives To examine associations between symptoms recorded in primary care and short-term hospitalisation and mortality in HF patients.Design Landmark analysis using Royston-Parmar survival models at baseline (diagnosis), 6 and 12 months post-diagnosis.Setting Primary care database (Clinical Practice Research Datalink) linked to hospital and mortality data (1998–2020).Participants Adults (>40 years) with a first HF diagnosis.Exposures Shortness of breath, ankle swelling, oedema, fatigue, chest pain, depression and anxiety in the 3 months before diagnosis and at 6 and 12 months.Outcomes 3-month all-cause hospitalisation and mortality; secondary outcomes included HF and non-cardiovascular hospitalisation.Results Among 86 882 HF patients (62 742 and 54 555 surviving to 6 and 12 months, respectively), the magnitude of symptom risk varied by timepoint. Specifically, the symptoms with the strongest associations with adverse outcomes were: depression for all-cause hospitalisation at diagnosis (HR: 1.26; 95% CI 1.15 to 1.39) and 6 months (1.46; 1.25 to 1.70); ankle swelling for mortality (1.49; 1.14 to 1.94) at 6 months and SOB for HF hospitalisation (1.18; 1.12 to 1.26) at diagnosis and 12 months (1.99; 1.68 to 2.35).Conclusions Symptoms persisted and were more prominent at 6 and 12 months post-diagnosis than at diagnosis.",
  "authors": [
    {
      "affiliations": [
        "Leicester Real World Evidence Unit, Department of Population and Health Sciences, University of Leicester, Leicester, UK",
        "Department of Cardiovascular Sciences, University of Leicester, Leicester, UK",
        "NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK",
        "Diabetes Research Centre, University of Leicester, Leicester, UK"
      ],
      "name": "Mohammad Rizwan Ali"
    },
    {
      "affiliations": [
        "National Heart Centre Singapore, 5 Hospital Drive, National University Singapore Faculty of Science, Singapore",
        "Duke-National University of Singapore Medical School, Singapore"
      ],
      "name": "Carolyn S P Lam"
    },
    {
      "affiliations": [
        "Department of Health, Medicine and Caring Sciences, Linkopings Universitet, Linköping, Sweden",
        "Department of Cardiology, Linköping University, Linköping, Sweden"
      ],
      "name": "Anna Stromberg"
    },
    {
      "affiliations": [
        "Department of Cardiovascular Sciences, University of Leicester, Leicester, UK",
        "Department of Population Health Sciences, University of Leicester, Leicester, UK"
      ],
      "name": "Simon P P Hand"
    },
    {
      "affiliations": [
        "Department of Population Health Sciences, University of Leicester, Leicester, UK"
      ],
      "name": "Sarah Booth"
    },
    {
      "affiliations": [
        "Leicester Real World Evidence Unit, Department of Population and Health Sciences, University of Leicester, Leicester, UK",
        "Diabetes Research Centre, University of Leicester, Leicester, UK"
      ],
      "name": "Francesco Zaccardi"
    },
    {
      "affiliations": [
        "Department of Cardiovascular Sciences, University of Leicester, Leicester, UK",
        "NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK"
      ],
      "name": "Gerry P McCann"
    },
    {
      "affiliations": [
        "Leicester Real World Evidence Unit, Department of Population and Health Sciences, University of Leicester, Leicester, UK",
        "Diabetes Research Centre, University of Leicester, Leicester, UK"
      ],
      "name": "Kamlesh Khunti"
    },
    {
      "affiliations": [
        "Leicester Real World Evidence Unit, Department of Population and Health Sciences, University of Leicester, Leicester, UK",
        "Department of Cardiovascular Sciences, University of Leicester, Leicester, UK",
        "NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK"
      ],
      "name": "Claire A Lawson"
    }
  ],
  "title": "Association of symptoms at heart failure diagnosis with hospitalisation and mortality at 6 and 12 months: a retrospective cohort study using UK primary care health records",
  "uid": "1057faa9-2350-54f1-a221-866867627b14"
}