Global Variations in Heart Failure Etiology, Management, and Outcomes

Medientyp: E-Artikel
Titel: Global Variations in Heart Failure Etiology, Management, and Outcomes
Beteiligte: Rasmussen, Mariela; Prado, Aldo; Hominal, Miguel A.; Zaidman, Cesar J.; Cursack, Guillermo; MacKinnon, Ignacio; Zapata, Gerardo; Rojas, David G.; Duran, Ruben G.; Vilamajo, Oscar G.; Dutra, Oscar P.; Oliveira, Lívia; Pavanello, Ricardo; Minelli, César; Sousa, Antonio; Maia, Lilia N.; Hernandes, Mauro E.; Oliveira, Múcio; De Souza, Weimar K. S. B.; Nobre, Fernando; Clausell, Nadine; Abib, Eduardo; Bazan, Silmeia Z.; Reis, Gilmar; [...]
Erschienen: American Medical Association (AMA), 2023
Erschienen in: JAMA
Sprache: Englisch
DOI: 10.1001/jama.2023.5942
ISSN: 0098-7484
Entstehung:
Anmerkungen:
Beschreibung: <jats:sec id="ab-joi230044-4"><jats:title>Importance</jats:title><jats:p>Most epidemiological studies of heart failure (HF) have been conducted in high-income countries with limited comparable data from middle- or low-income countries.</jats:p></jats:sec><jats:sec id="ab-joi230044-5"><jats:title>Objective</jats:title><jats:p>To examine differences in HF etiology, treatment, and outcomes between groups of countries at different levels of economic development.</jats:p></jats:sec><jats:sec id="ab-joi230044-6"><jats:title>Design, Setting, and Participants</jats:title><jats:p>Multinational HF registry of 23 341 participants in 40 high-income, upper–middle-income, lower–middle-income, and low-income countries, followed up for a median period of 2.0 years.</jats:p></jats:sec><jats:sec id="ab-joi230044-7"><jats:title>Main Outcomes and Measures</jats:title><jats:p>HF cause, HF medication use, hospitalization, and death.</jats:p></jats:sec><jats:sec id="ab-joi230044-8"><jats:title>Results</jats:title><jats:p>Mean (SD) age of participants was 63.1 (14.9) years, and 9119 (39.1%) were female. The most common cause of HF was ischemic heart disease (38.1%) followed by hypertension (20.2%). The proportion of participants with HF with reduced ejection fraction taking the combination of a β-blocker, renin-angiotensin system inhibitor, and mineralocorticoid receptor antagonist was highest in upper–middle-income (61.9%) and high-income countries (51.1%), and it was lowest in low-income (45.7%) and lower–middle-income countries (39.5%) (<jats:italic>P</jats:italic> &amp;lt; .001). The age- and sex- standardized mortality rate per 100 person-years was lowest in high-income countries (7.8 [95% CI, 7.5-8.2]), 9.3 (95% CI, 8.8-9.9) in upper–middle-income countries, 15.7 (95% CI, 15.0-16.4) in lower–middle-income countries, and it was highest in low-income countries (19.1 [95% CI, 17.6-20.7]). Hospitalization rates were more frequent than death rates in high-income countries (ratio = 3.8) and in upper–middle-income countries (ratio = 2.4), similar in lower–middle-income countries (ratio = 1.1), and less frequent in low-income countries (ratio = 0.6). The 30-day case-fatality rate after first hospital admission was lowest in high-income countries (6.7%), followed by upper–middle-income countries (9.7%), then lower–middle-income countries (21.1%), and highest in low-income countries (31.6%). The proportional risk of death within 30 days of a first hospital admission was 3- to 5-fold higher in lower–middle-income countries and low-income countries compared with high-income countries after adjusting for patient characteristics and use of long-term HF therapies.</jats:p></jats:sec><jats:sec id="ab-joi230044-9"><jats:title>Conclusions and Relevance</jats:title><jats:p>This study of HF patients from 40 different countries and derived from 4 different economic levels demonstrated differences in HF etiologies, management, and outcomes. These data may be useful in planning approaches to improve HF prevention and treatment globally.</jats:p></jats:sec>

Nur in Feld suchen:

Zuletzt gesuchte Begriffe: