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5-year outcome of acute heart failure in korea: results from the korean acute heart failure registry (KorAHF)

Session Moderated Poster Session - Acute heart failure

Speaker Gyu Chul Oh

Congress : Heart Failure 2019

  • Topic : heart failure
  • Sub-topic : Acute Heart Failure - Epidemiology, Prognosis, Outcome
  • Session type : Moderated Posters
  • FP Number : 51

Authors : GC Oh (Seoul,KR), HJ Cho (Seoul,KR), HY Lee (Seoul,KR), MC Cho (Cheongju,KR), BH Oh (Incheon,KR)

Authors:
GC Oh1 , HJ Cho1 , HY Lee1 , MC Cho2 , BH Oh3 , 1Seoul National University Hospital, Cardiology - Seoul - Korea (Republic of) , 2Chungbuk National University Hospital, Cardiology - Cheongju - Korea (Republic of) , 3Mediplex Sejong Hospital, Cardiology - Incheon - Korea (Republic of) ,

On behalf: KorAHF

Citation:

Background: Heart failure (HF) is associated with high mortality and cost, and even with current advances in medicine, the prevalence of HF is on a steady increase. 
Purpose: The Korean Acute Heart Failure registry (KorAHF) evaluated the clinical characteristics, treatment, and long-term outcome of patients hospitalized for acute HF.
Methods: Patients were prospectively enrolled in 10 university hospitals nationwide from March 2011 to February 2014. A total of 5 625 patients were followed up for up to 5.9 years. Primary outcome was death and readmission due to HF. Total outcome of hospitalized HF patients, along with outcomes in relation to etiology and left ventricular ejection fraction (LVEF) were analyzed. The proportion of patients adhering to guideline-recommended therapies were additionally assessed.
Results: The mean age of patients was 68.5 (14.5) years, and 53.2% were male. De novo HF compromised 52.2% of the patients, and 37.6% of total enrolled patients had ischemic etiologies. Acute HF due to ischemic etiologies showed poorer in-hospital, 1-year, and long-term outcomes compared with non-ischemic HF. In relation to LV systolic function, 57.4% of the patients were classified as heart failure with reduced ejection fraction (HFrEF). For these group of patients, there were no differences in survival compared to either heart failure with mid-range or preserved ejection fraction. Regarding oral treatment, guideline-based therapies such as renin-angiotensin system blockers, beta-blockers, and mineralocorticoid receptor blockers were used in 73, 55, and 51% of patients with HFrEF.
Conclusion: This registry provides information on the current status and prognosis of acute HF in Korea. Although the proportion of ischemic HF is lower than previous global registries, these patients have worse outcome, suggesting that closer monitoring and treatment is needed.

Ischemic

(n=2113)

Non-ischemic

(n=3512)

p

Age (years)

71.9 ± 10.9

66.5 ± 15.9

<0.001

Male (%)

61.5

48.2

<0.001

Diabetes

56.2

30.2

<0.001

LVEF40%

68.7

55.9

<0.001

ACEI/ARBs at discharge

67.1

65.2

0.147

Beta-blockers at discharge

54.7

47.0

<0.001

MRAs at discharge

39.6

48.1

<0.001

In-hospital mortality (%)

6.5

4.1

<0.001

LVEF, left ventricular ejection fraction; ACEI, angiotensin converting enzyme inhibitor; ARB, angiotensin receptor blocker; MRA, mineralocorticoid receptor blocker.


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