Hung-Yu Chang1, Chun-Chieh Wang2, Yen-Wen Wu3, Pao-Hsien Chu2, Chih-Cheng Wu4, Chih-Hsin Hsu5, Ming-Shien Wen2, Wen-Chol Voon6, Wei-Shiang Lin7, Jin-Long Huang8, Shyh-Ming Chen9, Ning-I Yang10, Heng-Chia Chang11, Kuan-Cheng Chang12, Shih-Hsien Sung13, Kou-Gi Shyu14, Jiunn-Lee Lin15, Guang-Yuan Mar16, Kuei-Chuan Chan17, Jen-Yuan Kuo18, Ji-Hung Wang19, Zhih-Cherng Chen20, Wei-Kung Tseng21, Wen-Jin Cherng10, Wei-Hsian Yin1. 1. Heart Center, Cheng Hsin General Hospital and Faculty of Medicine, School of Medicine, National Yang Ming University, Taipei. 2. Division of Cardiology, Chang Gung Memorial Hospital, Linkou. 3. Cardiology Division of Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City. 4. Cardiovascular Center, National Taiwan University Hospital, Hsinchu Branch, Hsinchu. 5. Institute of Clinical Medicine, National Cheng Kung University, College of Medicine, National Cheng Kung University, Tainan. 6. Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung. 7. Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital and National Defense Medical Center, Taipei. 8. Cardiovascular Center, Taichung Veterans General Hospital, Taichung. 9. Section of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung. 10. Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung. 11. Division of Cardiology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City. 12. Division of Cardiovascular Medicine and Cardiovascular Research Laboratory, China Medical University Hospital, Taichung. 13. Division of Cardiology, Taipei Veterans General Hospital. 14. Division of Cardiology, Shin Kong Wu Ho-Su Memorial Hospital. 15. Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei. 16. Division of Cardiology, Kaohsiung Veterans General Hospital, Kaohsiung. 17. Department of Internal Medicine, Chung-Shan Medical University Hospital, Taichung. 18. Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei. 19. Division of Cardiology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien. 20. Division of Cardiovascular Medicine, Chimei Medical Center, Tainan. 21. Division of Cardiology, Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan.
Abstract
BACKGROUND: Heart failure (HF) is a global health problem. The Taiwan Society of Cardiology-Heart Failure with reduced Ejection Fraction (TSOC-HFrEF) registry was a multicenter, observational survey of patients admitted with HFrEF in Taiwan. The aim of this study was to report the one-year outcome in this large-cohort of hospitalized patients presenting with acute decompensated HFrEF. METHODS: Patients hospitalized for acute HFrEF were recruited in 21 hospitals in Taiwan. A total of 1509 patients were enrolled into the registry by the end of October 2014. Clinical status, readmission rates and dispensed medications were collected and analyzed 1 year after patient index hospitalization. RESULTS: Our study indicated that re-hospitalization rates after HFrEF were 31.9% and 38.5% at 6 and 12 months after index hospitalization, respectively. Of these patients, 9.7% of them were readmitted more than once. At 6 and 12 months after hospital discharge, all-cause mortality rates were 9.5% and 15.9%, respectively, and cardiovascular mortality rates were 6.8% and 10.5%, respectively. Twenty-three patients (1.5%) underwent heart transplantation. During a follow-up period of 1 year, 46.4% of patients were free from mortality, HF re-hospitalization, left ventricular assist device use and heart transplantation. At the conclusion of follow-up, 57.5% of patients were prescribed either with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers; also, 66.3% were prescribed with beta-blockers and 40.8% were prescribed with mineralocorticoid receptor antagonists. CONCLUSIONS: The TSOC-HFrEF registry showed evidence of suboptimal practice of guideline-directed medical therapy and high HF re-hospitalization rate in Taiwan. The one-year mortality rate of the TSOC-HFrEF registry remained high. Ultimately, our data indicated a need for further improvement in HF care.
BACKGROUND:Heart failure (HF) is a global health problem. The Taiwan Society of Cardiology-Heart Failure with reduced Ejection Fraction (TSOC-HFrEF) registry was a multicenter, observational survey of patients admitted with HFrEF in Taiwan. The aim of this study was to report the one-year outcome in this large-cohort of hospitalized patients presenting with acute decompensated HFrEF. METHODS:Patients hospitalized for acute HFrEF were recruited in 21 hospitals in Taiwan. A total of 1509 patients were enrolled into the registry by the end of October 2014. Clinical status, readmission rates and dispensed medications were collected and analyzed 1 year after patient index hospitalization. RESULTS: Our study indicated that re-hospitalization rates after HFrEF were 31.9% and 38.5% at 6 and 12 months after index hospitalization, respectively. Of these patients, 9.7% of them were readmitted more than once. At 6 and 12 months after hospital discharge, all-cause mortality rates were 9.5% and 15.9%, respectively, and cardiovascular mortality rates were 6.8% and 10.5%, respectively. Twenty-three patients (1.5%) underwent heart transplantation. During a follow-up period of 1 year, 46.4% of patients were free from mortality, HF re-hospitalization, left ventricular assist device use and heart transplantation. At the conclusion of follow-up, 57.5% of patients were prescribed either with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers; also, 66.3% were prescribed with beta-blockers and 40.8% were prescribed with mineralocorticoid receptor antagonists. CONCLUSIONS: The TSOC-HFrEF registry showed evidence of suboptimal practice of guideline-directed medical therapy and high HF re-hospitalization rate in Taiwan. The one-year mortality rate of the TSOC-HFrEF registry remained high. Ultimately, our data indicated a need for further improvement in HF care.
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