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The present study aimed to investigate the 5-year survival and medication status of patients with chronic heart failure (HF) and reduced ejection fraction (HFrEF) in China. This study is a single-center, retrospective study and patients with HF and a left ventricular ejection fraction (LVEF) of ≤45%, were consecutively enrolled. The study population of 685 patients was divided into two groups, namely, LVEF ≤35 (n=371) and LVEF 36-45% (n=314). The patients were followed up for a median of 31 months (range, 8-61 months) and during this period, 24% of patients receiving angiotension-converting enzyme inhibitor/angiotensin receptor blocker (ACEI/ARB) treatment and 23% of those receiving β-blockers reached the maximum tolerated dose. Of the 191 total mortalities (28%), 127 were due to pump failure (19%) and 42 (6%) were sudden deaths. A Cox proportional hazards regression model was used to identify the variables associated with the risk of mortality. Kaplan-Meier curves and log-rank tests were used to compare the survival times of patients in the LVEF ≤35% and LVEF of 36-45% groups. The predictors of all-cause mortality were advanced age, body mass index, New York Heart Association functional class and lack of oral β-blockers at discharge. Patients with HFrEF have poor prognoses in China, particularly those patients with an LVEF of ≤35%. Therefore, cardiologists should strive to improve the prognosis of HF among Chinese patients and focus on the importance of the practical application of HF diagnosis and treatment guidelines.

Prognosis of patients with heart failure and reduced ejection fraction in China