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. 2019 May;21(5):577-587.
doi: 10.1002/ejhf.1347. Epub 2018 Dec 10.

Heart failure with reduced ejection fraction: comparison of patient characteristics and clinical outcomes within Asia and between Asia, Europe and the Americas

Pooja Dewan  1 , Pardeep S Jhund  1 , Li Shen  1 , Mark C Petrie  1 , William T Abraham  2 , M Atif Ali  3 , Chen-Huan Chen  4 , Akshay S Desai  5 , Kenneth Dickstein  6 , Jun Huang  7 , Songsak Kiatchoosakun  8 , Kee-Sik Kim  9 , Lars Køber  10 , Wen-Ter Lai  11 , Yuhua Liao  12 , Ulrik M Mogensen  1   10 , Byung-Hee Oh  13 , Milton Packer  14 , Jean L Rouleau  15 , Victor Shi  3 , Antonio S Sibulo Jr  16 , Scott D Solomon  5 , Piyamitr Sritara  17 , Karl Swedberg  18   19 , Hiroyuki Tsutsui  20 , Michael R Zile  21 , John J V McMurray  1
Affiliations

Heart failure with reduced ejection fraction: comparison of patient characteristics and clinical outcomes within Asia and between Asia, Europe and the Americas

Pooja Dewan et al. Eur J Heart Fail. 2019 May.

Abstract

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.

Keywords: Asia; Heart failure.

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Figures

Figure 1
Figure 1
Cardiovascular outcomes of interest, shown as rates per 100 patient‐years (unadjusted). (A) Primary composite outcome (cardiovascular death or heart failure hospitalization). (B) Heart failure hospitalization. (C) Cardiovascular death. (D) All‐cause death.
See this image and copyright information in PMC

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