Contemporary Epidemiology, Management, and Outcomes of Patients Hospitalized for Heart Failure in China: Results From the China Heart Failure (China-HF) Registry

Zhang, Yuhui; Zhang, Jian; Butler, Javed; Yang, Xianghong; Xie, Peiyi; Guo, Dongshuang; Wei, Tiemin; Yu, Jing; Wu, Zhen-Li; Gao, Yuan; Han, Xiumin; Zhang, Xuelian; Su-sheng, Wen; Anker, Stefan D.; Filippatos, Gerasimos; Fonarow, Gregg C.; Gan, Tianyi; Zhang, Rongcheng; Investigators, China-HF

doi:10.1016/j.cardfail.2017.09.014

Cited by 179 publications

(178 citation statements)

References 23 publications

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“…In a cross‐sectional study of participants of the Flemish Study on Environment Genes and Health Outcomes (FLEMENGHO), approximately 50% of hypertensive subjects had impairments in LV diastolic function, whereas only 12% of normotensive subjects could be classified as having abnormalities in LV diastolic function . The China Heart Failure (China‐HF) registry study recruited 13 687 patients with a primary discharge diagnosis of HF and found that common co‐morbidities included hypertension (50.9%), coronary heart disease (49.6%), and atrial fibrillation (24.4%) . The presence of these co‐morbidities has been associated with severe outcomes among patients with acute HF, such as a longer duration of hospitalization, higher rates of rehospitalization, or mortality …”

Section: Discussionmentioning

confidence: 99%

“…31 The China Heart Failure (China-HF) registry study recruited 13 687 patients with a primary discharge diagnosis of HF and found that common co-morbidities included hypertension (50.9%), coronary heart disease (49.6%), and atrial fibrillation (24.4%). 32 The presence of these co-morbidities has been associated with severe outcomes among patients with acute HF, such as a longer duration of hospitalization, higher rates of rehospitalization, or mortality. [33][34][35] Hypertension is one of the most common co-morbidities of HF, but the data on the treatment and control in HF patients are scarce.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence of heart failure and left ventricular dysfunction in China: the China Hypertension Survey, 2012–2015

Hao

Wang

Chen

et al. 2019

European J of Heart Fail

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214

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Background Heart failure (HF) is a major health burden worldwide. However, there is no nationwide epidemiological data on HF in China after 2000. The aims of this study are (i) to determine the prevalence of left ventricular (LV) dysfunction and HF (with reduced, mid‐range, and preserved ejection fraction) in a nationally representative Chinese population, and (ii) to investigate the treatment and control of hypertension in HF patients. Methods and results Data from the China Hypertension Survey (CHS) and 22 158 participants were eligible for analysis in this study. For each participant, a self‐reported history of HF and any other cardiovascular diseases was acquired. Two‐dimensional and Doppler echocardiography was used to assess LV dysfunction. Overall, 1.3% (estimated 13.7 million) of the Chinese adult population aged ≥35 years had HF, 1.4% of participants had LV systolic dysfunction (ejection fraction <50%), and 2.7% were graded as having ‘moderate’ or ‘severe’ LV diastolic dysfunction. The weighted prevalence of HF was similar between urban and rural residents (1.6% vs. 1.1%, P = 0.266), and between men and women (1.4% vs. 1.2%, P = 0.632). In addition, among HF patients with hypertension, 57.7% received antihypertensive medication, and 14.5% had their blood pressure controlled <140/90 mmHg. Conclusions In summary, there was an increase in the prevalence of HF, and LV dysfunction was very common in China. However, treatment and control of hypertension in participants with HF were low. Clinical trial registration number: ChiCTR‐ECS‐14004641.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prevalence of heart failure and left ventricular dysfunction in China: the China Hypertension Survey, 2012–2015

Hao

Wang

Chen

et al. 2019

European J of Heart Fail

Self Cite

214

165

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“…Clinical care for acute HF patients varies tremendously across different levels of health care facilities in China, yet reporting of the variation of this evidence–practice gap is limited. Previous Chinese HF registries were either retrospective studies without long‐term follow‐up data or were limited to large medical centres that were not representative of China's diverse health system ( Table ) . Thus, our study will provide a valuable opportunity to assess contemporary HF management and associated outcomes among a broader range of the Chinese health system.…”

Section: Discussionmentioning

confidence: 99%

Assessing the evidence–practice gap for heart failure in China: the Heart Failure Registry of Patient Outcomes (HERO) study design and baseline characteristics

Liu

Jiang

et al. 2019

European J of Heart Fail

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Background Registry studies in high‐income countries have defined contemporary management of heart failure (HF), but few such data exist in the large aging population of China. We report the study design and baseline characteristics of the Heart Failure Registry of Patient Outcomes (HERO) study, undertaken to determine evidence–practice gaps in the management of HF in a broad and representative population of China. Methods and results The HERO study is a prospective, longitudinal, seasonally‐rotating, multicentre registry study of patients hospitalized with acute HF who are followed up over 12 months. Patients were recruited on the basis of primary admission clinical diagnosis of acute HF at 73 hospitals in Henan, the largest and most socio‐economically diverse province in China, from November 2017 to November 2018; follow‐up is ongoing. For each patient, data obtained through interview and medial record review by independent clinical research staff include: socio‐demographics, clinical features, diagnostic investigations, and treatment, with a subset of patients providing blood samples for future biomarker investigation. Surviving patients are scheduled to be followed up by telephone at 2 weeks, and 3, 6 and 12 months post‐admission, or until death or study withdrawal. A total of 5620 patients (mean age 72 ± 12 years; 50% female) with acute HF were recruited from 8 provincial‐, 22 municipal‐, and 43 county‐level hospitals. Patients had co‐morbid hypertensive (48%), coronary (29%), or metabolic (20%) diseases. Among 3147 patients who had echocardiography, 54%, 20% and 25% of patients had ejection fraction of ≥50%, 40–50%, and < 40%, respectively. In‐hospital or 3‐day post‐discharge mortality was 3.2% (182/5620). Death or readmission rate from the 4th day post‐discharge to first follow‐up (median 32 days) was 22.4% (977/4368). Conclusions The HERO study provides a unique opportunity to profile evidence–practice gaps across a broad spectrum of patients with acute HF in China.

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“…Because the underlying data from the Kaplan-Meier curves were not presented in the publication, the necessary parameters were derived using the software tool Get Data Graph Digitizer (Braunschweig, Germany) referred to other literature [15,20] , the linear function was simulated by Microsoft Excel 2016 and Kaplan Meier curve was drawn to calculate the all-cause mortality and hospitalization rate in 30 days. The 30-day in-hospital death data and 30-day rehospitalization data were derived from the results of the Heart Failure Registry of Patient Outcomes (HERO) study and the China HF study respectively [21,22] . The monthly transition probabilities are presented in Table 1.…”

Section: Transition Probabilitiesmentioning

confidence: 99%

“…To investigate the effects of uncertainty in the model, univariate sensitivity analyses were performed by changing the relevant variables and their ranges. The range was taken from 95% confidence interval from the reported literature [8,[21][22][23][24][25][26] . The results of each parameter on ICER were displayed as a tornado diagram.…”

Section: Sensitivity Analysesmentioning

confidence: 99%

Economic evaluation of sacubitril/valsartan versus enalapril in the treatment of heart failure with reduced ejection fraction

Sang¹,

Jiang²,

Wang³

et al. 2020

Preprint

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Background: In 2020, sacubitril/valsartan(formerly LCZ696) will implement the new negotiated price of medical insurance in China, and the cost of treatment will be significantly reduced. The aim of study is to evaluate the economy of sacubitril/valsartan(SAC/VAL) compared with an angiotensin converting enzyme inhibitor (ACEI) (enalapril) in the treatment of heart failure with reduced ejection fraction (HFrEF) in China.Method: A Markov model was developed to project clinical and economic outcomes of SAC/VAL versus enalapril for 64-year-old patients with HFrEF over 10 years from the Chinese medical and health system perspective. A cost-utility analysis was performed mostly based on data from the PARADIGM trial. Other transition probability, costs, and utilities were obtained from published literature and public databases. The primary outcome were total and incremental costs and quality-adjusted life years (QALYs) and the incremental cost-effectiveness ratio (ICER) for SAC/VAL relative to enalapril. The model was verified the uncertainty using the sensitivity analysis furtherly.Results: Compared with enalapril, SAC/VAL cost more than enalapril (¥96532 vs. ¥34560) and was more cost-effective (4.6 QALYs vs. 4.3 QALYs), resulting in an incremental cost-effectiveness ratio of ¥185720 per QALY gained for patients with HFrEF at a WTP threshold of ¥212676 per QALY. Sensitivity analysis demonstrated the robustness of the model, identifying the death on the SAC/VAL group as a significant drivers of the cost-effectiveness. At the national negotiation price (¥9.95 per 100mg), probability of SAC/VAL being cost-effective was about 53% at a WTP threshold of ¥212676 per QALY.Conclusion: SAC/VAL was associated with clinical benefit and may be cost-effective compared with an ACEI (the current standard of care) in patients with HFrEF.

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Contemporary Epidemiology, Management, and Outcomes of Patients Hospitalized for Heart Failure in China: Results From the China Heart Failure (China-HF) Registry

Cited by 179 publications

References 23 publications

Prevalence of heart failure and left ventricular dysfunction in China: the China Hypertension Survey, 2012–2015

Prevalence of heart failure and left ventricular dysfunction in China: the China Hypertension Survey, 2012–2015

Assessing the evidence–practice gap for heart failure in China: the Heart Failure Registry of Patient Outcomes (HERO) study design and baseline characteristics

Economic evaluation of sacubitril/valsartan versus enalapril in the treatment of heart failure with reduced ejection fraction

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