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The mortality impact of recurrent cardiac hospitalizations has not been delineated in community-based heart failure patients. We determined if a “dose-dependent” relationship exists between heart failure events and death, accounting for temporal changes in age, comorbidities, and disease severity.

Among heart failure patients in the Enhanced Feedback For Effective Cardiac Treatment Study with onset between April 1999 and March 2001, we compared long-term survival (until March 2006) in those with recurrent heart failure or cardiovascular events, relative to those free of such events.

In 9138 patients, 28,442 person-years of follow-up were examined (mean age: 75.3 years, 49.6% male). Recurrent heart failure events occurred 1, 2, 3, and ≥4 times in 2352 (25.7%), 1020 (11.2%), 505 (5.5%), and 596 (6.5%) patients, respectively. Cardiovascular readmissions occurred 1, 2 …