The Singapore Heart Failure Outcomes and Phenotypes (SHOP) Study and Prospective Evaluation of Outcome in Patients With Heart Failure With Preserved Left Ventricular Ejection Fraction (PEOPLE) Study: Rationale and Design

Santhanakrishnan, Rajalakshmi; Ng, Tze Pin; Cameron, Vicky A.; Gamble, Greg; Ling, Lieng H.; Sim, David; Leong, Gerard; Yeo, Poh Shuan Daniel; Ong, Hean Yee; Jaufeerally, Fazlur; Wong, Raymond; Chai, Ping; Low, Adrian; Lund, Mayanna; Devlin, Gerry; Troughton, Richard W.; Richards, A. Mark; Doughty, Robert N.; Lam, Carolyn S.P.

doi:10.1016/j.cardfail.2013.01.007

Cited by 62 publications

(70 citation statements)

References 38 publications

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“…Data were combined from the studies of Coordinating Study Evaluating Outcomes of Advising and Counseling in Heart Failure (COACH) and the Singapore Heart Failure Outcomes and Phenotypes (SHOP) 14, 15, 16…”

Section: Methodsmentioning

confidence: 99%

“…The SHOP study prospectively enrolled 1099 HF patients from six different centres in Singapore. The main objective of the SHOP study is to document the prevalence, characteristics, and outcomes of Asian HF patients in Singapore and to determine the relative proportion of HFpEF patients in this population 16. The Asian population used in this study refers to a SHOP sub‐cohort of 578 patients with NT‐proBNP measurements available at discharge following hospitalization (see Supporting Information, Figure S1 ).…”

Section: Methodsmentioning

confidence: 99%

“…The Asian population used in this study refers to a SHOP sub‐cohort of 578 patients with NT‐proBNP measurements available at discharge following hospitalization (see Supporting Information, Figure S1 ). Inclusion and exclusion criteria were similar for both studies, which both included patients >18 years of age, either presenting as new onset HF or having previous HF hospitalizations 15, 16. In both studies, blood sampling for NT‐proBNP assay was performed at or around discharge after hospitalization for acute decompensated HF 15, 16.…”

Section: Methodsmentioning

confidence: 99%

“…Inclusion and exclusion criteria were similar for both studies, which both included patients >18 years of age, either presenting as new onset HF or having previous HF hospitalizations 15, 16. In both studies, blood sampling for NT‐proBNP assay was performed at or around discharge after hospitalization for acute decompensated HF 15, 16. Only participants recruited as inpatients were included in this report.…”

Section: Methodsmentioning

confidence: 99%

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N‐terminal pro‐B‐type natriuretic peptide and prognosis in Caucasian vs. Asian patients with heart failure

et al. 2018

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AimsN‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) is the most frequently used biomarker in heart failure (HF), but its prognostic utility across ethnicities is unclear.Methods and resultsThis study included 546 Caucasians with HF from the Coordinating Study Evaluating Outcomes of Advising and Counseling in Heart Failure and 578 Asians with HF from the Singapore Heart Failure Outcomes and Phenotypes study. NT‐proBNP was measured at discharge after HF hospitalization. The studied outcome was a composite of all‐cause mortality and HF hospitalization at 18 months. Compared with Caucasian patients, Asian patients were younger (63 ± 12 vs. 71 ± 11 years); less often female (26% vs. 39%); and had lower body mass index (26 vs. 27 kg/m2), better renal function (61 ± 37 vs. 54 ± 20 mL/min/1.73 m2), lower rates of atrial fibrillation (25% vs. 46%), strikingly higher rates of diabetes (59% vs. 30%), and higher rates of hypertension (76% vs. 44%). Despite these clear inter‐group differences in individual drivers of NT‐proBNP, average levels were similar in Asians [2709 (1350, 6302) pg/mL] and Caucasians [2545 (1308, 5484) pg/mL] (P = 0.514). NT‐proBNP was strongly associated with outcome [hazard ratio 1.28 (per doubling), 95% confidence interval 1.18–1.39, P < 0.001], regardless of ethnicity (P interaction = 0.719). NT‐proBNP was similarly associated with outcome in HF with reduced and preserved ejection fraction in Asian (P interaction = 0.776) and Caucasian patients (P interaction = 0.558).ConclusionsNT‐proBNP has similar prognostic performance in Asians and Caucasians with HF despite ethnic differences in known clinical determinants of plasma NT‐proBNP.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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N‐terminal pro‐B‐type natriuretic peptide and prognosis in Caucasian vs. Asian patients with heart failure

et al. 2018

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“…Clinical samples were obtained from the previously described Singapore Heart Failure Outcomes and Phenotypes Study (23,24 ). EDTA-anticoagulated plasma samples were collected from June 2010 to May 2013 from 255 patients (age 31-91 years) with a confirmed clinical diagnosis of HF and from 160 volunteers (age 36 -81 years) with no history of coronary artery disease or HF recruited to the Singapore Longitudinal Aging Study (23,24 ).…”

Section: Study Populationmentioning

confidence: 99%

High-Sensitivity Sandwich ELISA for Plasma NT-proUcn2: Plasma Concentrations and Relationship to Mortality in Heart Failure

et al. 2016

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BACKGROUND Urocortin 2 (Ucn2) has powerful hemodynamic, renal, and neurohormonal actions and likely participates in normal circulatory homeostasis and the compensatory response to heart failure (HF). A validated assay for endogenous circulating Ucn2 would facilitate investigations into Ucn2 physiology and elucidate its derangement and potential as a biomarker in heart disease. METHOD We developed a chemiluminescence-based sandwich ELISA to measure plasma N-terminal (NT)-proUcn2 in non-HF patients (control; n = 160) and HF patients with reduced (HFREF; n = 134) and preserved (HFPEF; n = 121) left ventricular ejection fraction (LVEF). RESULTS The ELISA had a limit of detection of 8.47 ng/L (1.52 pmol/L) and working range of 23.8–572 ng/L. Intra- and interassay CV and total error were 4.8, 16.2, and 17.7%, respectively. The median (interquartile range) plasma NT-proUcn2 concentration in controls was 112 (86–132) ng/L. HFREF, HFPEF, and all HF plasma concentrations were significantly increased [117 (98–141) ng/L, P = 0.0007; 119 (93–136) ng/L, P = 0.0376, and 119 (97–140) ng/L, P = 0.001] compared with controls but did not differ significantly between HFREF and HFPEF. NT-proUcn2 was modestly related to age (r = 0.264, P = 0.001) and cardiac troponin T (r = 0.258, P = 0.001) but not N-terminal pro-B-type natriuretic peptide, body mass index, LVEF, or estimated glomerular filtration rate. On multivariate analysis, plasma NT-proUcn2 was independently and inversely related to 2-year mortality in HF. CONCLUSIONS The validated ELISA measured human NT-proUcn2 in plasma and showed modest but significant increases in HF patients compared with controls. In HF, the unusual inverse relationship between plasma NT-proUcn2 and 2-year mortality portends potential prognostic value but requires further corroboration.

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Ethnic differences in quality of life and its association with survival in patients with heart failure

Stein

Teng

Tay

et al. 2020

Clinical Cardiology

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Background Optimizing quality of life (QoL) is a key priority in the management of heart failure (HF). Hypothesis To investigate ethnic differences in QoL and its association with 1‐year survival among patients with HF. Methods A prospective nationwide cohort (n = 1070, mean age: 62 years, 24.5% women) of Chinese (62.3%), Malay (26.7%) and Indian (10.9%) ethnicities from Singapore, QoL was assessed using the Minnesota Living with HF Questionnaire (MLHFQ) at baseline and 6 months. Patients were followed for all‐cause mortality. Results At baseline, Chinese had a lower (better) mean MLHFQ total score (29.1 ± 21.6) vs Malays (38.5 ± 23.9) and Indians (41.7 ± 24.5); P < .001. NYHA class was the strongest independent predictor of MLHFQ scores (12.7 increment for class III/IV vs I/II; P < .001). After multivariable adjustment (including NT‐proBNP levels, medications), ethnicity remained an independent predictor of QoL (P < .001). Crude 1‐year mortality in the overall cohort was 16.5%. A 10‐point increase of the physical component (of MLHFQ) was associated with a hazard (HR 1.22, 95% 1.03‐1.43) of 1‐year mortality (P = .018) in the overall cohort. An interaction between MLHFQ and ethnicity was found (P = .019), where poor MLHFQ score (per 10‐point increase) predicted higher adjusted mortality only in Chinese (total score: HR 1.18 [95% CI 1.07‐1.30]; physical: HR 1.44 [95% CI 1.17‐1.75]; emotional score: HR 1.45 [95% CI 1.05‐2.00]). Conclusions Ethnicity is an independent determinant of QoL in HF. Despite better baseline QoL in Chinese, QoL was more strongly related to survival in Chinese vs Malays and Indians. These findings have implications for HF trials that use patient‐reported outcomes as endpoints.

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The Singapore Heart Failure Outcomes and Phenotypes (SHOP) Study and Prospective Evaluation of Outcome in Patients With Heart Failure With Preserved Left Ventricular Ejection Fraction (PEOPLE) Study: Rationale and Design

Cited by 62 publications

References 38 publications

N‐terminal pro‐B‐type natriuretic peptide and prognosis in Caucasian vs. Asian patients with heart failure

N‐terminal pro‐B‐type natriuretic peptide and prognosis in Caucasian vs. Asian patients with heart failure

High-Sensitivity Sandwich ELISA for Plasma NT-proUcn2: Plasma Concentrations and Relationship to Mortality in Heart Failure

Ethnic differences in quality of life and its association with survival in patients with heart failure

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