Heart Failure Statistics in Korea, 2020: A Report from the Korean Society of Heart Failure

Abstract

Background and objectives: Heart failure (HF) is a disease with high morbidity and mortality. With ageing society and increasing prevalence of risk factors of HF, the prevalence of HF is expected to increase, as well. In this official report of the Korean Society of Heart Failure the epidemiology of HF in Korea is presented.

Methods: The data of Korean National Health Insurance big data, the Korean Heart Failure (KorHF) and the Korean Acute Heart Failure (KorAHF) registries have been used.

Results: In 2018, the prevalence, incidence, mortality of HF patients, and mortality due to HF were 2,261, 579, 245, and 10.4 per 100.000 persons, respectively. Regarding the temporal trend, there was a continuous increase in HF prevalence (0.77% in 2002, 1.48% in 2013, and 2.24% in 2018) and HF related deaths. The most common etiology for HF was ischemic origin, and the dominant subtype was HF with reduced ejection fraction (EF), defined as EF ≤40%. Of these, 77.6%, 58.0%, and 55.1% received renin-angiotensin-system inhibitors (angiotensin-converting-enzyme inhibitors or angiotensin-receptor-blockers), beta-blockers, and aldosterone-antagonists, respectively. In 2018, 1,542 implantable cardiac defibrillators and 272 cardiac resynchronization therapy devices were implanted, and 176 patients received heart transplantation. With improvement of pharmacologic and non-pharmacological therapy, the survival time of HF has been improving in the last 2 decades; nonetheless, it is associated with enormous increase in medical costs.

Conclusions: The prevalence of HF has been increasing in Korea. With improvement of therapy, the prognosis of HF has been improving, too. Nonetheless, appropriate interventions are necessary to prevent HF.

Keywords: Epidemiology; Heart failure; Korea; Statistics.

Figure 1. Prevalence of HF. (A) Estimated prevalence of patients with HF between 2002 and 2018. (B) Temporal trend of crude and age-adjusted prevalence of patients with HF. (C) Temporal trend of prevalence of patients with HF according to age and sex between 2002 and 2018.

HF = heart failure.

Figure 2. Incidence of HF. Temporal trend of crude and age-adjusted incidence of patients with HF (upper panel) and that of inpatients with HF (lower panel) between 2004 and 2018.

HF = heart failure.

Figure 3. Morality of HF. (A) Temporal trend of crude and age-adjusted mortality of patients with HF (upper panel) and that of inpatients with HF (lower panel) between 2002 and 2018. (B) Temporal trend of survival from HF diagnosis in patients with HF (left) and that in inpatients with HF (right). (C) Temporal trend of crude and age-adjusted mortality due to HF in patients with HF (upper panel) and that in inpatients with HF (lower panel) between 2002 and 2018.

HF = heart failure.

Figure 4. Heart transplantation in Korea. (A) Temporal trend of comorbidities (left panel) between 2004 and 2018 and medications in 2018 (right panel). (B) ICD and CRT implantation between 2016 and 2019. (C) Heart transplantation between 2000 and 2019.

ACEi = angiotensin-converting-enzyme inhibitor; AF = atrial fibrillation; ARB = angiotensin-receptor-blocker; BB = beta-blockers; CKD = chronic kidney disease; CVA = cerebrovascular accident; CRT = cardiac resynchronization therapy; DCM = dilated cardiomyopathy; DM = diabetes mellitus; HCM = hypertrophic cardiomyopathy; HTN = hypertension; ICD = implantable cardioverter defibrillator; IHD = ischemic heart disease; RAS = renin-angiotensin-system; VHD = valvular heart disease.

Figure 5. Medical cost of HF. Temporal trend of total medical cost (left panel) and the cost for each hospitalization and each outpatient clinic visit (right panel) between 2002 and 2018.

HF = heart failure; KRW = Korean won.