BACKGROUND: Heart failure (HF) represents a major public health issue in an aging population. Although HF is a leading cause of morbidity and mortality in developed countries, the clinical features of HF in Japan remain unclear. METHODS AND RESULTS: This observational cohort study analyzed data from the Heart Institute of Japan--Department of Cardiology (HIJC)-HF Registry, which is based on a nationwide survey by the HIJC, Tokyo Women's Medical University and its affiliated hospitals. Of 3,578 consecutive patients (average age, 69.8 years; females 40.7%) hospitalized for HF between January 2001 and December 2002, 95.0% were followed up until the end of 2005 (median, 2.8 years). The 1- and 3-year mortality rates were 11.3% and 29.2%, respectively. Multivariate analysis revealed that advanced age (hazard ratio 1.71 [95% confidence interval 1.38-2.12]; p<0.001), symptomatic HF at hospital discharge (3.76 [2.30-6.17]; p<0.001), renal impairment (1.96 [1.50-2.57]; p=0.008), anemia (1.46 [1.18-1.80]; p=0.02) and low pulse pressure (2.88 [1.62-5.13]; p=0.0003) were significantly associated with total death. CONCLUSION: Although the long-term mortality rate for Japanese patients with HF is lower than in other countries, several markers are modifiable. The data demonstrate that continued improvements in the treatment of Japanese patients with HF are still needed.
BACKGROUND:Heart failure (HF) represents a major public health issue in an aging population. Although HF is a leading cause of morbidity and mortality in developed countries, the clinical features of HF in Japan remain unclear. METHODS AND RESULTS: This observational cohort study analyzed data from the Heart Institute of Japan--Department of Cardiology (HIJC)-HF Registry, which is based on a nationwide survey by the HIJC, Tokyo Women's Medical University and its affiliated hospitals. Of 3,578 consecutive patients (average age, 69.8 years; females 40.7%) hospitalized for HF between January 2001 and December 2002, 95.0% were followed up until the end of 2005 (median, 2.8 years). The 1- and 3-year mortality rates were 11.3% and 29.2%, respectively. Multivariate analysis revealed that advanced age (hazard ratio 1.71 [95% confidence interval 1.38-2.12]; p<0.001), symptomatic HF at hospital discharge (3.76 [2.30-6.17]; p<0.001), renal impairment (1.96 [1.50-2.57]; p=0.008), anemia (1.46 [1.18-1.80]; p=0.02) and low pulse pressure (2.88 [1.62-5.13]; p=0.0003) were significantly associated with total death. CONCLUSION: Although the long-term mortality rate for Japanese patients with HF is lower than in other countries, several markers are modifiable. The data demonstrate that continued improvements in the treatment of Japanese patients with HF are still needed.
Authors: Joerg C Schefold; Gerasimos Filippatos; Gerd Hasenfuss; Stefan D Anker; Stephan von Haehling Journal: Nat Rev Nephrol Date: 2016-08-30 Impact factor: 28.314