Clinical Characteristics and Outcome of Acute Heart Failure in Korea: Results from the Korean Acute Heart Failure Registry (KorAHF)

Abstract

Background and ObjectivesThe burden of heart failure has increased in Korea. This registry aims to evaluate demographics, clinical characteristics, management, and long-term outcomes in patients hospitalized for acute heart failure (AHF).Subjects and MethodsWe prospectively enrolled a total of 5625 consecutive subjects hospitalized for AHF in one of 10 tertiary university hospitals from March 2011 to February 2014. Descriptive statistics were used to determine the baseline characteristics of the study population and to compare them with those from other registries.ResultsThe mean age was 68.5±14.5 years, 53.2% were male, and 52.2% had de novo heart failure. The mean systolic and diastolic blood pressures were 131.2±30.3 mmHg and 78.6±18.8 mmHg at admission, respectively. The left ventricular ejection fraction was ≤40% in 60.5% of patients. Ischemia was the most frequent etiology (37.6%) and aggravating factor (26.3%). Angiotensin converting enzyme inhibitors/angiotensin receptor blockers, beta-blockers, and aldosterone antagonists were prescribed in 68.8%, 52.2%, and 46.6% of the patients at discharge, respectively. Compared with the previous registry performed in Korea a decade ago, extracorporeal membrane oxygenation (ECMO) and heart transplantation have been performed more frequently (ECMO 0.8% vs. 2.8%, heart transplantation 0.3% vs. 1.2%), and in-hospital mortality decreased from 7.6% to 4.8%. However, the total cost of hospital care increased by 40%, and one-year follow-up mortality remained high.ConclusionWhile the quality of acute clinical care and AHF-related outcomes have improved over the last decade, the long-term prognosis of heart failure is still poor in Korea. Therefore, additional research is needed to improve long-term outcomes and implement cost-effective care.

Treatment outcome and its predictors among patients of acute heart failure at a tertiary care hospital in Ethiopia: a prospective observational study

“…Patients admitted in this study were young (median = 34 years). This was contrary to registries in ADHERE (mean = 72.4), OPTIMIZE-HF (mean = 73), OFICA (median = 79.0), Korean Acute Heart Failure Registry (Kor-AHF) (mean = 68.5) and the sub-Saharan Africa Survey of Heart Failure cohort (mean = 52.3) [5,12,15,19,20]. Reason for younger age admission could be related to the high prevalence of RHD in Ethiopia [21].…”

Comparison of Characteristics and 3-Year Outcomes in Patients With Acute Heart Failure With Preserved, Mid-Range, and Reduced Ejection Fraction

“…The rationale and detailed study design of the KorAHF registry have been presented in previous publications. 8,9 Briefly, the KorAHF registry is an ongoing, prospective nationwide multicenter cohort in Korea, which aims to describe the patient demographics, clinical characteristics, and outcomes of AHF. Patients hospitalized with signs or symptoms of AHF were consecutively enrolled from 10 representative university hospitals in Korea between March 2011 and February 2014.…”

Hyponatraemia and its prognosis in acute heart failure is related to right ventricular dysfunction

“…Two prospective studies with pulmonary arterial hypertension demonstrated similar results, noting that hyponatraemia was associated with right HF 11 12. Similarly, in the Korean Acute Heart Failure (KorAHF) registry, the prevalence of hyponatraemia was significantly higher in patients with isolated right HF than in those with other HF subtypes (27.1% vs 20.9%, p=0.002) 13. Here, we hypothesised that hyponatraemia might be associated with RV dysfunction in patients with AHF, which accounts for the poor prognosis.…”