Physicians’ Perception of the Patient Care Pathway for Acute Heart Failure in Asian Countries: Implications for Resource Allocation, Preventive Strategies and Clinical Trial Design

Lansang, Elvira Zenaida; Horsburgh, David; Lee, Yun Ning; Sng, Adeline; Moussalli, R; Wai, Karen M.; Anand, Inder; Zhang, Shu; Shimizu, Wataru; Narasimhan, Calambur; Park, Sang Weon; Yu, Cheuk‐Man; Ngarmukos, Tachapong; Omar, Razali; Reyes, Eugene B.; Siswanto, Bambang Budi; Richards, A. Mark; Lam, Carolyn S.P.

doi:10.7603/s40602-014-0015-z

Cited by 2 publications

(3 citation statements)

References 32 publications

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“…As a result, the youngest group (phenotype 4), despite having the least number of comorbidities, reported the highest rate of VHD and AF (79.8% and 62.9%). In contrast, in high-income nations, the youngest phenotype was often associated with obesity, diabetes, and multiple risk factors, whereas the eldest phenotype often showed highest prevalence of AF [ 7 , 19 , 27 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

“…Conflicting data exists regarding the prevalence, presentation, and mortality, indicating a heterogeneous profile across geographical and ethnic compositions of Asia [ 16 – 18 ]. HFpEF contributed more than 50% of heart failure in Japan and Hong Kong, whereas it only represented one-fifth in ASIAN-HF trial [ 17 , 19 ]. One-year mortality ranged from 2.9% in South Asia to 10.3% in South East Asia, with an overall of 5.4% in 11 Asian countries [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

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Clinical Phenotypes and Age-Related Differences in Presentation, Treatment, and Outcome of Heart Failure with Preserved Ejection Fraction: A Vietnamese Multicenter Research

Nguyen

Tran

et al. 2021

Cardiology Research and Practice

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Background. Heart failure with preserved ejection fraction (HFpEF) is a rising health problem with heterogeneous presentation and no evidence-based treatment. While Southeast Asia reported the highest mortality and morbidity among Asian population, little is known about the Vietnamese population, including patient characteristics, prescribing pattern and mortality rate. Methods. We conducted an observational study on 477 patients diagnosed with HFpEF from seven hospitals in Southern Vietnam from January 2019 to December 2019. Results. Mean age was 67.6 (40.9% < 65 years). 62.3% were female. 82.4% were diagnosed within 5 years. Dyspnea, congestion, and hypoperfusion on admission were noted in 63.9%, 48.8%, and 4.6% of the patients, respectively. Median ejection fraction was 63%. Valvular heart disease (VHD) was the leading cause of heart failure (35.9%). 78.6% had at least two comorbidities, mostly hypertension (68.6%). 30.6% of the patients were hospitalized, with a median stay of 7.0 (4.0–10.0) days and inhospital mortality of 4.8%. Older patients (≥65 years) were more likely to be females (OR = 1.52); had multimorbid conditions (OR = 3.14), including hypertension (OR = 4.28), diabetes (OR = 1.73), coronary artery disease (CAD) (OR = 2.50), dyslipidemia (OR = 1.94), and chronic kidney disease (OR = 2.44); and were more frequently prescribed statin (OR = 3.15). Younger individuals (<65 years) were associated with higher mineralocorticoid antagonist uptake (OR = 0.52) and VHD (OR = 0,40). Prescription rate for renin-angiotensin-aldosterone system inhibitor, beta blocker, mineralocorticoid antagonist, and loop diuretic was 72.5%, 59.1%, 43.0%, and 60.6%, respectively. Four phenotypes were identified, including the lean/elderly/multimorbid; congestive/metabolic; CAD-induced; and younger/atrial fibrillation (AF)/VHD. The novel phenotype “younger/AF/VHD” exhibited high symptom burden and poor functional capacity despite being the youngest and least multimorbid. The “lean/elderly/multimorbid” phenotype demonstrated the highest symptom severity and inhospital mortality. Conclusions. Our research highlights a younger, predominantly female population with high disease burden. The four novelly identified phenotypes provide contemporary and pragmatic insights into a phenotype-guided approach, exclusively targeting the Vietnamese population.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical Phenotypes and Age-Related Differences in Presentation, Treatment, and Outcome of Heart Failure with Preserved Ejection Fraction: A Vietnamese Multicenter Research

Nguyen

Tran

et al. 2021

Cardiology Research and Practice

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“…HFpEF constitutes half of the HF population in the Western population; a little is known regarding the prevalence of HFpEF in Asians. Lansang et al reported that HFrEF was the predominant form of Acute HF presenting to the cardiologic centers in Asia. Among the 12 Asian countries/regions studied, HFpEF was reported to be common only in Hongkong (55%) and Japan (50%) consistent with the findings in the United States (US).…”

Section: Heart Failure With Reduced Vs Preserved Ejection Fraction (Hmentioning

confidence: 99%

An overview of hypertension and cardiac involvement in Asia: Focus on heart failure

Soenarta

Buranakitjaroen

Chia

et al. 2020

J of Clinical Hypertension

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Cardiovascular Disease (CVD) is the leading cause of deaths worldwide, contributing to about 30% of all deaths. Half of the cases of CVD are estimated in Asia, the world's most populous continent. Hypertension, a major modifiable risk factor for and CME seminars from Abbott, Bayer, Boehringer Ingelheim, GlaxoSmithKline, Menarini, Merck Sharp & Dohme, Novartis, Orient Europharma, Pfizer, and Sanofi; and a research grant from Pfizer. J Nailes has received research grants from Pfizer. J Shin has received honoraria and sponsorship to attend seminars from Daiichi Sankyo, Takeda, Menarini, MSD, Bristol-Myers Squibb, and Sanofi. CH Chen has served as an advisor or consultant for Novartis PharmaceuticalsCorporation and has served as a speaker or a member of a speakers

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Physicians’ Perception of the Patient Care Pathway for Acute Heart Failure in Asian Countries: Implications for Resource Allocation, Preventive Strategies and Clinical Trial Design

Cited by 2 publications

References 32 publications

Clinical Phenotypes and Age-Related Differences in Presentation, Treatment, and Outcome of Heart Failure with Preserved Ejection Fraction: A Vietnamese Multicenter Research

Clinical Phenotypes and Age-Related Differences in Presentation, Treatment, and Outcome of Heart Failure with Preserved Ejection Fraction: A Vietnamese Multicenter Research

An overview of hypertension and cardiac involvement in Asia: Focus on heart failure

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