Heart Failure-Attributed Mortality in Europe, 2012–2021
Bibliographic record
Abstract
AIMS: Heart failure (HF) is a leading cause of cardiovascular mortality worldwide. However, comprehensive and updated assessments of HF-attributable mortality trends across Europe are limited. The aim of this study was to evaluate HF-attributed mortality trends in Europe between 2012 and 2021, examining variations by age, sex, and European region. METHODS AND RESULTS: We extracted HF-attributed mortality data from the World Health Organization (WHO) mortality dataset for 2012-2021. Age-adjusted mortality rates (AAMRs) were analysed using joinpoint regression modelling, expressed as average annual percent change (AAPC) with 95% confidence intervals (CIs). A parallelism test compared trend differences across groups. To explore contributors to HF-attributable mortality, we analysed the mean alcohol consumption and the age-adjusted prevalence and trends of smoking habit, arterial hypertension (HTN), obesity and type 2 diabetes mellitus (DM) using the WHO non-communicable diseases dataset (2012-2021). From 2012 to 2021, 4 872 634 individuals (2 084 521 men and 2 788 113 women) died due to HF, equating to 11 522 deaths per 100 000 population. Overall, the AAMR increased (AAPC: +0.4% [95% CI 0.3-0.5], p < 0.001), with a significantly greater increase in men compared to women (p for parallelism = 0.02). HF-attributable mortality trend had a higher increase among patients aged less than 70 years compared to those aged 70 years or older (p for parallelism = 0.001). Regionally, AAMRs increased in Western (AAPC: +1.2% [95% CI 1.0-1.4], p < 0.001), Eastern (AAPC: +0.9% [95% CI 0.7-1.0], p < 0.001) and Northern Europe (AAPC: +0.5 [95% CI 0.3-0.6], p < 0.001) while plateaued in Southern Europe (AAPC: +3.2% [95% CI -3.2 to 10.1], p = 0.28). A similar increase was observed in the trend for AAMR in HF-attributable mortality among subjects died due to HF with reduced or preserved ejection fraction (p for parallelism = 0.18). During the same period, the age-adjusted prevalence of overweight, obesity and DM rose, while HTN, smoking habit and alcohol consumption decreased. CONCLUSIONS: Heart failure-attributed mortality in Europe increased between 2012 and 2021. Substantial disparities persist across European regions and countries.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".