Jasper Tromp1,2, Joost C Beusekamp3, Wouter Ouwerkerk4,5, Peter van der Meer3, John G F Cleland6, Christiane E Angermann7, Ulf Dahlstrom8, Georg Ertl7, Mahmoud Hassanein9, Sergio V Perrone10, Mathieu Ghadanfar11, Anja Schweizer12, Achim Obergfell12, Gerasimos Filippatos13, Kenneth Dickstein14, Sean P Collins15, Carolyn S P Lam2,3,4. 1. Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore. 2. Duke-NUS Medical School, Singapore. 3. University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. 4. National Heart Centre Singapore, Singapore. 5. Department of Dermatology, Amsterdam UMC, University of Amsterdam, Amsterdam Infection & Immunity Institute, Amsterdam, The Netherlands. 6. Robertson Centre for Biostatistics and Clinical Trials, Institute of Health & Well-Being, University of Glasgow and National Heart & Lung Institute, Imperial College, London, UK. 7. Comprehensive Heart Failure Centre, University Hospital and University of Würzburg, Würzburg, Germany. 8. Department of Cardiology and Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden. 9. Alexandria University, Faculty of Medicine, Cardiology Department Alexandria, Egypt. 10. El Cruce Hospital by Florencio Varela, Lezica Cardiovascular Institute, Sanctuary of the Trinidad Miter, Buenos Aires, Argentina. 11. M-Ghadanfar Consulting (Life Sciences), Basel, Switzerland. 12. Novartis Pharma AG, Basel, Switzerland. 13. University of Cyprus, School of Medicine & National and Kapodistrian University of Athens, School of Medicine, Department of Cardiology, Attikon University Hospital, Athens, Greece. 14. University of Bergen, Stavanger University Hospital, Norway. 15. Vanderbilt University Medical Center and Veterans Affairs Tennessee Valley Healthcare System, Geriatric Research, Education and Clinical Center (GRECC), Department of Emergency Medicine, Nashville, Tennessee, USA.
Abstract
AIMS: Few prior studies have investigated differences in precipitants leading to hospitalizations for acute heart failure (AHF) in a cohort with global representation. METHODS AND RESULTS: We analysed the prevalence of precipitants and their association with outcomes in 18 553 patients hospitalized for AHF in REPORT-HF (prospective international REgistry to assess medical Practice with lOngitudinal obseRvation for Treatment of Heart Failure) according to left ventricular ejection fraction subtype (reduced [HFrEF] and preserved ejection fraction [HFpEF]) and presentation (new-onset vs. decompensated chronic heart failure [DCHF]). Patients were enrolled from 358 centres in 44 countries stratified according to Latin America, North America, Western Europe, Eastern Europe, Eastern Mediterranean and Africa, Southeast Asia, and Western Pacific. Precipitants were pre-with mutually exclusive categories and selected according to the local investigator's discretion. Outcomes included in-hospital and 1-year mortality. The median age was 67 (interquartile range 57-77) years, and 39% were women. Acute coronary syndrome (ACS) was the most common precipitant in patients with new-onset heart failure in all regions except for North America and Western Europe, where uncontrolled hypertension and arrhythmia, respectively, were the most common precipitants, independent of confounders. In patients with DCHF, non-adherence to diet/medication was the most common precipitant regardless of region. Uncontrolled hypertension was a more likely precipitant in HFpEF, non-adherence to diet/medication, and ACS were more likely precipitants in HFrEF. Patients admitted due to worsening renal function had the worst in-hospital (5%) and 1-year post-discharge (30%) mortality rates, regardless of region, heart failure subtype and admission type (pinteraction >0.05 for all). CONCLUSION: Data on global differences in precipitants for AHF highlight potential regional differences in targets for preventing hospitalization for AHF and identifying those at highest risk for early mortality.
AIMS: Few prior studies have investigated differences in precipitants leading to hospitalizations for acute heart failure (AHF) in a cohort with global representation. METHODS AND RESULTS: We analysed the prevalence of precipitants and their association with outcomes in 18 553 patients hospitalized for AHF in REPORT-HF (prospective international REgistry to assess medical Practice with lOngitudinal obseRvation for Treatment of Heart Failure) according to left ventricular ejection fraction subtype (reduced [HFrEF] and preserved ejection fraction [HFpEF]) and presentation (new-onset vs. decompensated chronic heart failure [DCHF]). Patients were enrolled from 358 centres in 44 countries stratified according to Latin America, North America, Western Europe, Eastern Europe, Eastern Mediterranean and Africa, Southeast Asia, and Western Pacific. Precipitants were pre-with mutually exclusive categories and selected according to the local investigator's discretion. Outcomes included in-hospital and 1-year mortality. The median age was 67 (interquartile range 57-77) years, and 39% were women. Acute coronary syndrome (ACS) was the most common precipitant in patients with new-onset heart failure in all regions except for North America and Western Europe, where uncontrolled hypertension and arrhythmia, respectively, were the most common precipitants, independent of confounders. In patients with DCHF, non-adherence to diet/medication was the most common precipitant regardless of region. Uncontrolled hypertension was a more likely precipitant in HFpEF, non-adherence to diet/medication, and ACS were more likely precipitants in HFrEF. Patients admitted due to worsening renal function had the worst in-hospital (5%) and 1-year post-discharge (30%) mortality rates, regardless of region, heart failure subtype and admission type (pinteraction >0.05 for all). CONCLUSION: Data on global differences in precipitants for AHF highlight potential regional differences in targets for preventing hospitalization for AHF and identifying those at highest risk for early mortality.
Authors: Piotr Ponikowski; Adriaan A Voors; Stefan D Anker; Héctor Bueno; John G F Cleland; Andrew J S Coats; Volkmar Falk; José Ramón González-Juanatey; Veli-Pekka Harjola; Ewa A Jankowska; Mariell Jessup; Cecilia Linde; Petros Nihoyannopoulos; John T Parissis; Burkert Pieske; Jillian P Riley; Giuseppe M C Rosano; Luis M Ruilope; Frank Ruschitzka; Frans H Rutten; Peter van der Meer Journal: Eur J Heart Fail Date: 2016-05-20 Impact factor: 15.534
Authors: Annika Rosengren; Andrew Smyth; Sumathy Rangarajan; Chinthanie Ramasundarahettige; Shrikant I Bangdiwala; Khalid F AlHabib; Alvaro Avezum; Kristina Bengtsson Boström; Jephat Chifamba; Sadi Gulec; Rajeev Gupta; Ehi U Igumbor; Romaina Iqbal; Norhassim Ismail; Philip Joseph; Manmeet Kaur; Rasha Khatib; Iolanthé M Kruger; Pablo Lamelas; Fernando Lanas; Scott A Lear; Wei Li; Chuangshi Wang; Deren Quiang; Yang Wang; Patricio Lopez-Jaramillo; Noushin Mohammadifard; Viswanathan Mohan; Prem K Mony; Paul Poirier; Sarojiniamma Srilatha; Andrzej Szuba; Koon Teo; Andreas Wielgosz; Karen E Yeates; Khalid Yusoff; Rita Yusuf; Afzalhusein H Yusufali; Marjan W Attaei; Martin McKee; Salim Yusuf Journal: Lancet Glob Health Date: 2019-04-23 Impact factor: 26.763
Authors: Elke Platz; Pardeep S Jhund; Brian L Claggett; Marc A Pfeffer; Karl Swedberg; Christopher B Granger; Salim Yusuf; Scott D Solomon; John J McMurray Journal: Eur J Heart Fail Date: 2017-09-04 Impact factor: 15.534
Authors: Gerasimos Filippatos; Christiane E Angermann; John G F Cleland; Carolyn S P Lam; Ulf Dahlström; Kenneth Dickstein; Georg Ertl; Mahmoud Hassanein; Kimberly W Hart; Christopher J Lindsell; Sergio V Perrone; Tadhg Guerin; Mathieu Ghadanfar; Anja Schweizer; Achim Obergfell; Sean P Collins Journal: JAMA Cardiol Date: 2020-04-01 Impact factor: 14.676
Authors: Ovidiu Chioncel; Alexandre Mebazaa; Veli-Pekka Harjola; Andrew J Coats; Massimo Francesco Piepoli; Maria G Crespo-Leiro; Cecile Laroche; Petar M Seferovic; Stefan D Anker; Roberto Ferrari; Frank Ruschitzka; Silvia Lopez-Fernandez; Daniela Miani; Gerasimos Filippatos; Aldo P Maggioni Journal: Eur J Heart Fail Date: 2017-04-30 Impact factor: 15.534
Authors: Gerasimos Filippatos; Sadiya Sana Khan; Andrew P Ambrosy; John G F Cleland; Sean P Collins; Carolyn S P Lam; Christiane E Angermann; Georg Ertl; Ulf Dahlström; Dayi Hu; Kenneth Dickstein; Sergio V Perrone; Mathieu Ghadanfar; Georgina Bermann; Adele Noe; Anja Schweizer; Thomas Maier; Mihai Gheorghiade Journal: Eur J Heart Fail Date: 2015-03-10 Impact factor: 15.534