Global Differences in Characteristics, Precipitants, and Initial Management of Patients Presenting With Acute Heart Failure

Filippatos, Gerasimos; Angermann, Christiane E.; Cleland, John G.F.; Lam, Carolyn S.P.; Dahlström, Ulf; Dickstein, Kenneth; Ertl, Georg; Hassanein, Mahmoud; Hart, Kimberly W.; Lindsell, Christopher J.; Perrone, Sergio V.; Guerin, Tadhg; Ghadanfar, Mathieu; Schweizer, Anja; Obergfell, Achim; Collins, Sean P.

doi:10.1001/jamacardio.2019.5108

Cited by 59 publications

(81 citation statements)

References 42 publications

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“…Our admission age (64 yrs) is relatively lower compared to high income countries such as the U.S. (73 years) and Western Europe (72 years) as expected, but is in line with other upper middle income countries like Jamaica and Brazil and higher than most countries in Africa and Asia. 32 , 33 , 34 , 35 , 36 , 37 The Hindustani sub-cohort was more frequently admitted for HF admissions, followed by Creole and Javanese which differs slightly from the size of the three largest ethnic groups in Suriname, respectively Hindustani, Tribal communities and Creole. 20 This difference may be partly explained by the differential access of care since the AZP is situated in the capital and people from the rural regions, specifically Tribal and Indigenous communities, may have difficulty accessing AZP health services.…”

Section: Resultsmentioning

confidence: 96%

Heart Failure Hospitalizations and Risk Factors among the Multi-Ethnic Population from a Middle Income Country: The Suriname Heart Failure Studies

Sairras

Baldew

Hilst

et al. 2021

Journal of the National Medical Association

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Introduction Heart failure (HF) is an emerging epidemic with poor disease outcomes and differences in its prevalence, etiology and management between and within world regions. Hypertension (HT) and ischemic heart disease (IHD) are the leading causes of HF. In Suriname, South-America, data on HF burden are lacking. The aim of this Suriname Heart Failure I (SUHF–I) study, is to assess baseline characteristics of HF admitted patients in order to set up the prospective interventional SUHF-II study to longitudinally determine the effectiveness of a comprehensive HF management program in HF patients. Methods A cross-sectional analysis was conducted of Thorax Center Paramaribo (TCP) discharge data from January 2013-December 2015. The analysis included all admissions with primary or secondary discharge of HF ICD-10 codes I50-I50.9 and I11.0 and the following variables: patient demographics (age, sex, and ethnicity), # of readmissions, risk factors (RF) for HF: HT, diabetes mellitus (DM), smoking, and left ventricle (LV) function. T-tests were used to analyze continuous variables and Chi-square test for categorical variables. Differences were considered statistically significant when a p-value <0.05 is obtained. Results 895 patients (1:1 sex ratio) with either a primary (80%) or secondary HF diagnosis were admitted. Female patients were significantly older (66.2 ± 14.8 years, p < 0.01) at first admission compared to male patients (63.5 ± 13.7 years) and the majority of admissions were of Hindustani and Creole descent. HT, DM and smoking were highly prevalent respectively 62.6%, 38.9 and 17.3%. There were 379 readmissions (29.1%) and 7% of all admissions were readmissions within 30 days and 16% were readmissions for 31-365 day. IHD is more prevalent in patients from Asian descendant (52.2%) compared to African descendant (11.7%). Whereas, HT (39.3%) is more prevalent in African descendants compared to Asian descendants (12.7%). There were no statistically significant differences in age, sex, ethnicity, LV function and RFs between single admitted and readmitted patients. Conclusion RF prevalence, ethnic differences and readmission rates in Surinamese HF patients are in line with reports from other Caribbean and Latin American countries. These results are the basis for the SUHF-II study which will aid in identifying the country specific and clinical factors for the successful development of a multidisciplinary HF management program.

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Section: Resultsmentioning

confidence: 96%

Heart Failure Hospitalizations and Risk Factors among the Multi-Ethnic Population from a Middle Income Country: The Suriname Heart Failure Studies

Sairras

Baldew

Hilst

et al. 2021

Journal of the National Medical Association

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“…Previous studies have also demonstrated higher mortality rates in HF patients with a lower BMI 4 – 8 . There is a global trend for progressive aging of HF patients 9 , 10 . BMI values are much lower in elderly patients than in younger individuals, and the overlap of aging and low BMI has been most prominently seen in Japan 11 .…”

Section: Introductionmentioning

confidence: 99%

Association between body mass index and prognosis of patients hospitalized with heart failure

Kato

Morimoto

Yaku

et al. 2020

Sci Rep

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The prognostic implications of very low body mass index (BMI) values remain unclear in patients with acute decompensated heart failure (ADHF). This study aimed to investigate the prognostic impact of BMI classification based on the World Health Organization criteria in patients with ADHF. Among 3509 patients with ADHF and available BMI data at discharge in 19 participating hospitals in Japan between October 2014 and March 2016, the study population was divided into five groups; (1) Severely underweight: BMI < 16 kg/m2, (2) Underweight: BMI ≥ 16 kg/m2 and < 18.5 kg/m2, (3) Normal weight: BMI ≥ 18.5 kg/m2 and < 25 kg/m2, (4) Overweight: BMI ≥ 25 kg/m2 and < 30 kg/m2 (5) Obese: BMI ≥ 30 kg/m2. The primary outcome measure was all-cause death. The median follow-up duration was 471 days, with 96.4% follow up at 1-year. The cumulative 1-year incidence of all-cause death was higher in underweight groups, and lower in overweight groups (Severely underweight: 36.3%, Underweight: 23.9%, Normal weight: 14.4%, Overweight: 7.9%, and Obese: 9.0%, P < 0.001). After adjusting confounders, the excess mortality risk remained significant in the severely underweight group (HR, 2.32; 95%CI, 1.83–2.94; P < 0.001), and in the underweight group (HR, 1.31; 95%CI, 1.08–1.59; P = 0.005) relative to the normal weight group, while the lower mortality risk was no longer significant in the overweight group (HR, 0.82; 95%CI, 0.62–1.10; P = 0.18) and in the obese group (HR, 1.09; 95%CI, 0.65–1.85; P = 0.74). Very low BMI was associated with a higher risk for one-year mortality after discharge in patients with ADHF.

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“…1 Patients hospitalized for HF have a particularly adverse prognosis, with a high risk of mortality and rehospitalization and account for approximately 70% of the total expenditure related to the syndrome. 2 As a result, HF is becoming a major challenge for the health care systems. 3 Several community-based studies and registries have consistently shown that evidencebased therapies are underused in real-life HF patients, while mortality and hospitalization rates are higher than those reported in randomized clinical trials.…”

Section: The Need For a Heart Failure Networkmentioning

confidence: 99%

How to develop a national heart failure clinics network: a consensus document of the Hellenic Heart Failure Association

Filippatos¹,

Farmakis²,

Alexanian³

et al. 2020

ESC Heart Failure

Self Cite

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Heart failure (HF) is rapidly growing, conferring considerable mortality, morbidity, and costs. Dedicated HF clinics improve patient outcomes, and the development of a national HF clinics network aims at addressing this need at national level. Such a network should respect the existing health care infrastructures, and according to the capacities of hosting facilities, it can be organized into three levels. Establishing the continuous communication and interaction among the components of the network is crucial, while supportive actions that can enhance its efficiency include involvement of multidisciplinary health care professionals, use of structured HF‐specific documents, such as discharge notes, patient information leaflets, and patient booklets, and implementation of an HF‐specific electronic health care record and database platform.

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Global Differences in Characteristics, Precipitants, and Initial Management of Patients Presenting With Acute Heart Failure

Cited by 59 publications

References 42 publications

Heart Failure Hospitalizations and Risk Factors among the Multi-Ethnic Population from a Middle Income Country: The Suriname Heart Failure Studies

Heart Failure Hospitalizations and Risk Factors among the Multi-Ethnic Population from a Middle Income Country: The Suriname Heart Failure Studies

Association between body mass index and prognosis of patients hospitalized with heart failure

How to develop a national heart failure clinics network: a consensus document of the Hellenic Heart Failure Association

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