Five‐year mortality of heart failure with preserved, mildly reduced, and reduced ejection fraction in a 4880 Chinese cohort

Chen, Shiqun; Huang, Zhidong; Zhao, Xiaoli; Aobuliksimu, Xiemuxikaimaier; Wang, Bo; He, Yibo; Kang, Yu Mi; Huang, Haozhang; Li, Qiang; Yao, Younan; Lü, Xin; Qian, Xiaoxian; Xie, Xujing; Liu, Jin; Liu, Yong

doi:10.1002/ehf2.13921

Cited by 24 publications

(18 citation statements)

References 42 publications

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“…A total of 7467 citations were identified from the initial PubMed, EMBASE, Cochrane Library. Following application of inclusion criteria, exclusion criteria, and quality assessment, 22 studies 16,26–46 with 248 323 patients were retained for the systematic review and meta‐analysis comparing AF prevalence and its impact of all‐cause mortality, HF hospitalization, CV, and stroke/TIA between HFrEF, HFmrEF, and HFpEF categories. Of these, 123 331 were HFrEF patients (49.7%); 40 995 HFmrEF (16.5%); and 83 997 HFpEF (33.8%).…”

Section: Resultsmentioning

confidence: 99%

Atrial fibrillation and risk of adverse outcomes in heart failure with reduced, mildly reduced, and preserved ejection fraction: A systematic review and meta‐analysis

Kroshian,

Joseph,

Kinlay

et al. 2024

Cardiovasc electrophysiol

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IntroductionHeart failure (HF) and atrial fibrillation (AF) frequently co‐exist. Contemporary classification of HF categorizes it into HF with reduced ejection fraction (HFrEF), HF with mildly reduced ejection fraction (HFmrEF), and HF with preserved ejection fraction (HFpEF). Aggregate data comparing the risk profile of AF between these three HF categories are lacking.MethodsWe conducted a systematic review and meta‐analysis aimed at determining any significant differences in AF‐associated all‐cause mortality, HF hospitalizations, cardiovascular mortality (CV), and stroke between HFrEF, HFmrEF, and HFpEF. A systematic search of PubMed, EMBASE, and Cochrane Library databases until February 28, 2023. Data were combined using DerSimonian‐Laird random effects model.ResultsA total of 22 studies comprising 248 323 patients were retained: HFrEF 123 331 (49.7%), HFmrEF 40 995 (16.5%), and HFpEF 83 997 (33.8%). Pooled baseline AF prevalence was 36% total population, 30% HFrEF, 36% HFmrEF, and 42% HFpEF. AF was associated with a higher risk of all‐cause mortality in the total population with pooled hazard ratio (HR) = 1.13 (95% confidence interval [CI] = 1.07−1.21), HFmrEF (HR = 1.25, 95% CI = 1.05−1.50) and HFpEF (HR = 1.16, 95% CI = 1.09−1.24), but not HFrEF (HR = 1.03, 95% CI = 0.93−1.14). AF was associated with a higher risk of HF hospitalizations in the total population (HR = 1.29, 95% CI = 1.14−1.46), HFmrEF (HR = 1.64, 95% CI = 1.20−2.24), and HFpEF (HR = 1.46, 95% CI = 1.17−1.83), but not HFrEF (HR = 1.01, 95% CI = 0.87−1.18). AF was only associated with CV in the HFpEF subcategory but was associated with stroke in all three HF subtypes.ConclusionsAF appears to be associated with a higher risk of all‐cause mortality and HF hospitalization in HFmrEF and HFpEF. With these findings, the paucity of data and treatment guidelines on AF in the HFmrEF subgroup becomes even more significant and warrant further investigations.

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Section: Resultsmentioning

confidence: 99%

Atrial fibrillation and risk of adverse outcomes in heart failure with reduced, mildly reduced, and preserved ejection fraction: A systematic review and meta‐analysis

Kroshian,

Joseph,

Kinlay

et al. 2024

Cardiovasc electrophysiol

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“…One‐sixth individuals with HF died in 5 years. HFrEF was associated with a nearly two‐fold increased risk of 5 year mortality than HFpEF 5 …”

Section: Risk Factors and Preventionmentioning

confidence: 96%

“…HFrEF was associated with a nearly two-fold increased risk of 5 year mortality than HFpEF. 5 The prevention of cardiac complication in patients after adjuvant breast cancer treatments is discussed by Bikiewicz et al 6 The patho-mechanisms of different chemotherapy and radiotherapy interventions are reviewed, with predictors of cardiovascular damage. The contributions of the new cardio-specific biomarkers in serum and of modern imaging techniques (global longitudinal strain and three-dimensional left ventricular ejection fraction) and genotyping, and especially their combined use in risk prediction are presented.…”

Section: Introductionmentioning

confidence: 99%

A year in heart failure: updates of clinical and preclinical findings

et al. 2023

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We witnessed major advances in the management of heart failure (HF) in 2022. Results of recent clinical and preclinical investigations aid preventive strategies, diagnostic efforts, and therapeutic interventions, and collectively, they hold promises for a more effective HF care for the near future. Accordingly, currently available information extends the 2021 European Society of Cardiology guidelines and provides a solid background for the introduction of improved clinical approaches in the number of HF‐related cases. Elaboration on the relationships between epidemiological data and risk factors lead to better understanding of the pathophysiology of HF with reduced ejection fraction and HF with preserved ejection fraction. The clinical consequences of valvular dysfunctions are increasingly interpreted not only in their haemodynamic consequences but also in association with their pathogenetic factors and modern corrective treatment possibilities. The influence of coronavirus disease 2019 pandemic on the clinical care of HF appeared to be less intense in 2022 than before; hence, this period allowed to refine coronavirus disease 2019 management options for HF patients. Moreover, cardio‐oncology emerges as a new subdiscipline providing significant improvements in clinical outcomes for oncology patients. Furthermore, the introduction of state‐of‐the‐art molecular biologic methods, multi‐omic approaches forecast improved phenotyping and precision medicine for HF. All above aspects are addressed in this article that highlights a selection of papers published in ESC Heart Failure in 2022.

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“…The transition probability for CHD, death, and in-hospital death was 0.0854, 1.0763, and 2.5665%, respectively. Using the same formula, we could draw that the transition probabilities for HF and stroke were 0.0229 and 0.0288%, and the transition probabilities for death and inhospital death for HF and stroke were 0.5368 vs. 0.8632% and 2.7683 vs. 1.5447% (Table 1) (20,21,23).…”

Section: Parameter Input Transition Probability Inputmentioning

confidence: 96%

Sacubitril-valsartan for the treatment of hypertension in China: A cost-utility analysis based on meta-analysis of randomized controlled trials

Lou

Liu²,

Huang³

2022

Front. Public Health

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BackgroundSacubitril-valsartan was recommended for heart failure (HF) and proven cost-effective in HF. Recently, sacubitril-valsartan has been recommended to treat hypertension by the Chinese expert consensus. The cost utility of sacubitril-valsartan for hypertension remains uninvestigated.MethodsA meta-analysis of randomized controlled trials (RCTs) was performed to investigate the real efficacy of sacubitril-valsartan on blood pressure, compared with angiotensin receptor blockers or placebo. A lifetime Markov model was developed to compare the cost utility of sacubitril-valsartan vs. valsartan. The primary outcome was the incremental cost-utility ratio (ICUR), representing the ratio of incremental costs to the incremental utility. The willingness-to-pay (WTP) threshold was three times of per capita gross domestic product (GDP) in China in 2021. Sacubitril-valsartan was considered cost-effective if the ICUR obtained was lower than the WTP threshold, otherwise, sacubitril-valsartanis was not cost-effective.ResultsA total of 10 RCTs of 5,781 patients were included in the meta-analysis. For comparison of sacubitril-valsartan 400 mg/day vs. valsartan 320 mg/day, a reduction in blood pressure (BP) of −5.97 (−6.38, −5.56) (p < 0.01) was observed. Cost-utility analysis showed that for a 60-year-old patient with hypertension, if sacubitril-valsartan was prescribed as the antihypertensive agent, he had a life expectancy of 11.91 quality-adjusted life-years (QALYs) with costs of 65,066 CNY, and if valsartan was prescribed as the antihypertensive agent, the life expectancy would be 11.82 QALY with costs of 54,769 CNY; thus, an ICUR of 108,622 CNY/QALY was obtained, lower than the WTP threshold.ConclusionCompared with valsartan, sacubitril-valsartan is more effective in reducing blood pressure and may result in more quality-adjusted life-year, although with higher costs. Sacubitril-valsartan is cost-effective for hypertension in the current China setting under the willingness-to-pay threshold of 3 times of per capita GDP.

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Five‐year mortality of heart failure with preserved, mildly reduced, and reduced ejection fraction in a 4880 Chinese cohort

Cited by 24 publications

References 42 publications

Atrial fibrillation and risk of adverse outcomes in heart failure with reduced, mildly reduced, and preserved ejection fraction: A systematic review and meta‐analysis

Atrial fibrillation and risk of adverse outcomes in heart failure with reduced, mildly reduced, and preserved ejection fraction: A systematic review and meta‐analysis

A year in heart failure: updates of clinical and preclinical findings

Sacubitril-valsartan for the treatment of hypertension in China: A cost-utility analysis based on meta-analysis of randomized controlled trials

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