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Heart failure with reduced ejection fraction: comparison of patient characteristics and clinical outcomes within Asia and between Asia, Europe and the Americas.

Journal article
Authors Pooja Dewan
Pardeep S Jhund
Li Shen
Mark C Petrie
William T Abraham
M Atif Ali
Chen-Huan Chen
Akshay S Desai
Kenneth Dickstein
Jun Huang
Songsak Kiatchoosakun
Kee-Sik Kim
Lars Køber
Wen-Ter Lai
Yuhua Liao
Ulrik M Mogensen
Byung-Hee Oh
Milton Packer
Jean L Rouleau
Victor Shi
Antonio S Sibulo
Scott D Solomon
Piyamitr Sritara
Karl Swedberg
Hiroyuki Tsutsui
Michael R Zile
John J V McMurray
Published in European journal of heart failure
Volume 21
Issue 5
Pages 577-587
ISSN 1879-0844
Publication year 2019
Published at Institute of Medicine, Department of Molecular and Clinical Medicine
Pages 577-587
Language en
Subject categories Clinical Medicine


Nearly 60% of the world's population lives in Asia but little is known about the characteristics and outcomes of Asian patients with heart failure with reduced ejection fraction (HFrEF) compared to other areas of the world.We pooled two, large, global trials, with similar design, in 13 174 patients with HFrEF (patient distribution: China 833, India 1390, Japan 209, Korea 223, Philippines 223, Taiwan 199 and Thailand 95, Western Europe 3521, Eastern Europe 4758, North America 613, and Latin America 1110). Asian patients were younger (55.0-63.9 years) than in Western Europe (67.9 years) and North America (66.6 years). Diuretics and devices were used less, and digoxin used more, in Asia. Mineralocorticoid receptor antagonist use was higher in China (66.3%), the Philippines (64.1%) and Latin America (62.8%) compared to Europe and North America (range 32.8% to 49.6%). The rate of cardiovascular death/heart failure hospitalization was higher in Asia (e.g. Taiwan 17.2, China 14.9 per 100 patient-years) than in Western Europe (10.4) and North America (12.8). However, the adjusted risk of cardiovascular death was higher in many Asian countries than in Western Europe (except Japan) and the risk of heart failure hospitalization was lower in India and in the Philippines than in Western Europe, but significantly higher in China, Japan, and Taiwan.Patient characteristics and outcomes vary between Asia and other regions and between Asian countries. These variations may reflect several factors, including geography, climate and environment, diet and lifestyle, health care systems, genetics and socioeconomic influences.

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