Global differences in burden and treatment of ischemic heart disease in acute heart failure: REPORT-HF

Tromp, J. et al. (2021) Global differences in burden and treatment of ischemic heart disease in acute heart failure: REPORT-HF. JACC: Heart Failure, 9(5), pp. 349-359. (doi: 10.1016/j.jchf.2020.12.015) (PMID:33839078)

Abstract

Objectives: The primary aim of the current study was to investigate global differences in prevalence, association with outcome, and treatment of ischemic heart disease (IHD) in patients with acute heart failure (AHF) in the REPORT-HF (International Registry to Assess Medical Practice With Longitudinal Observation for Treatment of Heart Failure) registry. Background: Data on IHD in patients with AHF are primarily from Western Europe and North America. Little is known about global differences in treatment and prognosis of patients with IHD and AHF. Methods: A total of 18,539 patients with AHF were prospectively enrolled from 44 countries and 365 centers in the REPORT-HF registry. Patients with a history of coronary artery disease, an ischemic event causing admission for AHF, or coronary revascularization were classified as IHD. Clinical characteristics, treatment, and outcomes of patients with and without IHD were explored. Results: Compared with 8,766 (47%) patients without IHD, 9,773 (53%) patients with IHD were older, more likely to have a left ventricular ejection fraction <40% (heart failure with reduced ejection fraction [HFrEF]), and reported more comorbidities. IHD was more common in lower income compared with high-income countries (61% vs. 48%). Patients with IHD from countries with low health care expenditure per capita or without health insurance less likely underwent coronary revascularization or used anticoagulants at discharge. IHD was independently associated with worse cardiovascular death (hazard ratio: 1.21; 95% confidence interval: 1.09 to 1.35). The association between IHD and cardiovascular death was stronger in HFrEF compared with heart failure with preserved ejection fraction (pinteraction <0.001). Conclusions: In this large global contemporary cohort of patients with AHF, IHD was more common in low-income countries and conveyed worse 1-year mortality, especially in HFrEF. Patients in regions with the greatest burden of IHD were less likely to receive coronary revascularization and treatment for IHD.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Cleland, Professor John
• Authors: Tromp, J., Ouwerkerk, W., Cleland, J. G.F., Angermann, C. E., Dahlstrom, U., Teng, K. T.-H., Bamadhaj, S., Ertl, G., Hassanein, M., Perrone, S. V., Ghandanfar, M., Schweizer, A., Obergfell, A., Filippatos, G., Collins, S. P., Lam, C. S.P., and Dickstein, K.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
• Journal Name: JACC: Heart Failure
• Publisher: Elsevier
• ISSN: 2213-1779
• ISSN (Online): 2213-1787
• Published Online: 07 April 2021
• Copyright Holders: Copyright © 2021 The American College of Cardiology Foundation
• First Published: First published in JACC: Heart Failure 9(5): 349-359
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher