Yuhui Zhang1, Jian Zhang2, Javed Butler3, Xiaomin Yang4, Peiyi Xie5, Dongshuang Guo6, Tiemin Wei7, Jing Yu8, Zhenli Wu9, Yingchun Gao9, Xiumin Han10, Xuelian Zhang11, Susheng Wen12, Stefan D Anker13, Gerasimos Filippatos14, Gregg C Fonarow15, Tianyi Gan1, Rongcheng Zhang1. 1. State Key Laboratory of Cardiovascular Disease, Heart Failure Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China. 2. State Key Laboratory of Cardiovascular Disease, Heart Failure Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China. Electronic address: fwzhangjian62@126.com. 3. Department of Medicine, Stony Brook University, Stony Brook, New York. 4. Department of Cardiology, Second Affiliated Hospital of Baotou Medical College, Baotou, Inner Mongolia, People's Republic of China. 5. Department of Cardiology, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, People's Republic of China. 6. Department of Cardiology, People's Hospital of Yuxian, Yangquan, Shanxi, People's Republic of China. 7. Department of Cardiology, Lishui Municipal Central Hospital, Lishui, Zhejiang University, Zhejiang, People's Republic of China. 8. Department of Cardiology, Lanzhou University Second Hospital, Lanzhou, Gansu, People's Republic of China. 9. Department of Cardiology, Inner Mongolia People's Hospital, Hohhot, Inner Mongolia, People's Republic of China. 10. Department of Cardiology, General Hospital of Shenyang Military, Shenyang, Liaoning, People's Republic of China. 11. Department of Cardiology, Urumqi Friendship Hospital, Urumqi, Xinjiang, People's Republic of China. 12. Department of Cardiology, first Hospital of Tianshui, Tianshui, Gansu, People's Republic of China. 13. Department of Cardiology and Pneumology, University Medical Center Göttingen, Göttingen, Germany. 14. National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital, Athens, Greece. 15. Ahmanson-UCLA Cardiomyopathy Center, University of California, Los Angeles, California.
Abstract
BACKGROUND: Contemporary data on the epidemiology of heart failure (HF) in China are scarce. The China-HF Registry was designed to investigate clinical characteristics, management, and outcomes of patients hospitalized for HF in China. METHODS AND RESULTS: Data were collected prospectively on 13,687 patients with a primary discharge diagnosis of HF who were enrolled from 132 participating hospitals from January 2012 to September 2015. Data from the China-HF Registry was compared with previously published literature. The mean age was 65 ± 15 years, 59.1% were male, and 36.0% had preserved ejection fraction. Age, body mass index, and systolic blood pressure were lower than in high-income countries. Common comorbidities included hypertension (50.9%), coronary heart disease (49.6%), and atrial fibrillation (24.4%). The overall use of diuretics, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (ACEI/ARB), and β-blockers at admission was 30.1%, 27.0%, and 25.6%, respectively, which was lower than in other registries. For patients discharged alive, ACEI/ARB, β-blocker, and mineralocorticoid receptor antagonist use in patients with reduced ejection fraction was 67.5%, 70.0%, and 74.1%, respectively; device use was much lower. The median length of hospital stay was 10 (range 7-15) days, and in-hospital mortality was 4.1 ± 0.3%. Predictors of mortality included low systolic blood pressure, acute myocardial infarction, infection, right bundle branch block, and elevated total bilirubin and blood urea nitrogen level. CONCLUSIONS: Several important findings in patient profile and treatment patterns among Chinese patients with HF were noted compared with published literature. These data underscore the need for regional characterization of HF for global clinical trials and for the identification of several quality improvement opportunities.
BACKGROUND: Contemporary data on the epidemiology of heart failure (HF) in China are scarce. The China-HF Registry was designed to investigate clinical characteristics, management, and outcomes of patients hospitalized for HF in China. METHODS AND RESULTS: Data were collected prospectively on 13,687 patients with a primary discharge diagnosis of HF who were enrolled from 132 participating hospitals from January 2012 to September 2015. Data from the China-HF Registry was compared with previously published literature. The mean age was 65 ± 15 years, 59.1% were male, and 36.0% had preserved ejection fraction. Age, body mass index, and systolic blood pressure were lower than in high-income countries. Common comorbidities included hypertension (50.9%), coronary heart disease (49.6%), and atrial fibrillation (24.4%). The overall use of diuretics, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (ACEI/ARB), and β-blockers at admission was 30.1%, 27.0%, and 25.6%, respectively, which was lower than in other registries. For patients discharged alive, ACEI/ARB, β-blocker, and mineralocorticoid receptor antagonist use in patients with reduced ejection fraction was 67.5%, 70.0%, and 74.1%, respectively; device use was much lower. The median length of hospital stay was 10 (range 7-15) days, and in-hospital mortality was 4.1 ± 0.3%. Predictors of mortality included low systolic blood pressure, acute myocardial infarction, infection, right bundle branch block, and elevated total bilirubin and blood ureanitrogen level. CONCLUSIONS: Several important findings in patient profile and treatment patterns among Chinese patients with HF were noted compared with published literature. These data underscore the need for regional characterization of HF for global clinical trials and for the identification of several quality improvement opportunities.