Premium
Heart failure with reduced ejection fraction: comparison of patient characteristics and clinical outcomes within Asia and between Asia, Europe and the Americas
Author(s) -
Dewan Pooja,
Jhund Pardeep S.,
Shen Li,
Petrie Mark C.,
Abraham William T.,
Atif Ali M.,
Chen ChenHuan,
Desai Akshay S.,
Dickstein Kenneth,
Huang Jun,
Kiatchoosakun Songsak,
Kim KeeSik,
Køber Lars,
Lai WenTer,
Liao Yuhua,
Mogensen Ulrik M.,
Oh ByungHee,
Packer Milton,
Rouleau Jean L.,
Shi Victor,
Sibulo Antonio S.,
Solomon Scott D.,
Sritara Piyamitr,
Swedberg Karl,
Tsutsui Hiroyuki,
Zile Michael R.,
McMurray John J.V.
Publication year - 2019
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1002/ejhf.1347
Subject(s) - medicine , china , ejection fraction , heart failure , latin americans , population , demography , geography , environmental health , political science , law , archaeology , sociology
Aims Nearly 60% of the world's population lives in Asia but little is known about the characteristics and outcomes of Asian patients with heart failure with reduced ejection fraction (HFrEF) compared to other areas of the world. Methods and results We pooled two, large, global trials, with similar design, in 13 174 patients with HFrEF (patient distribution: China 833, India 1390, Japan 209, Korea 223, Philippines 223, Taiwan 199 and Thailand 95, Western Europe 3521, Eastern Europe 4758, North America 613, and Latin America 1110). Asian patients were younger (55.0–63.9 years) than in Western Europe (67.9 years) and North America (66.6 years). Diuretics and devices were used less, and digoxin used more, in Asia. Mineralocorticoid receptor antagonist use was higher in China (66.3%), the Philippines (64.1%) and Latin America (62.8%) compared to Europe and North America (range 32.8% to 49.6%). The rate of cardiovascular death/heart failure hospitalization was higher in Asia (e.g. Taiwan 17.2, China 14.9 per 100 patient‐years) than in Western Europe (10.4) and North America (12.8). However, the adjusted risk of cardiovascular death was higher in many Asian countries than in Western Europe (except Japan) and the risk of heart failure hospitalization was lower in India and in the Philippines than in Western Europe, but significantly higher in China, Japan, and Taiwan. Conclusion Patient characteristics and outcomes vary between Asia and other regions and between Asian countries. These variations may reflect several factors, including geography, climate and environment, diet and lifestyle, health care systems, genetics and socioeconomic influences.