Global Variations in Heart Failure Etiology, Management, and Outcomes.

Autor:	Joseph P; Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada., Roy A; Department of Cardiology, All India Institute of Medical Sciences, New Delhi, Delhi, India., Lonn E; Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada., Störk S; Department Clinical Research and Epidemiology, Comprehensive Heart Failure Center, Department Internal Medicine, University Hospital, Würzburg, Germany., Floras J; Mount Sinai Hospital, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada., Mielniczuk L; University of Ottawa, University of Ottawa Heart Institute, Ottawa, Ontario, Canada., Rouleau JL; Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada., Zhu J; FuWai Hospital, Beijing, China., Dzudie A; Department of Global Health and Population, Lown Scholars Program, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.; Cape Heart Institute, University of Cape Town, Cape Town, South Africa.; Faculty of Medicine and Biomedical Sciences, University of Yaounde, Yaounde, Cameroon.; Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa., Balasubramanian K; Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada., Karaye K; Bayero University and Aminu Kano Teaching Hospital, Department of Medicine, Kano, Nigeria., AlHabib KF; Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia., Gómez-Mesa JE; Fundación Valle Del Lili, Department of Cardiology and Universidad Icesi, Cali, Colombia., Branch KR; University of Washington, Cardiology, Seattle., Makubi A; Community Development, Gender, Elderly, and Children, Ministry of Health, Dodoma, Tanzania., Budaj A; Centre of Postgraduate Medical Education, Department of Cardiology, Grochowski Hospital, Warsaw, Poland., Avezum A; International Research Center, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil., Wittlinger T; Department of Cardiology, Asklepios Hospital Goslar, Goslar, Germany., Ertl G; Department Clinical Research and Epidemiology, Comprehensive Heart Failure Center, Department Internal Medicine, University Hospital, Würzburg, Germany., Mondo C; Kiruddu National Referral Hospital, Kampala, Uganda., Pogosova N; Medical Research Center of Cardiology named after E.I. Chazov, Moscow, Russia., Maggioni AP; ANMCO Research Center, Heart Care Foundation, Florence, Italy., Orlandini A; Estudios Clínicos Latino America Collaborative Group, Rosario, Argentina., Parkhomenko A; Emergency Cardiology Department, National Scientific Centre, Strazhesko Institute of Cardiology, Kiev, Ukraine., ElSayed A; Alzaeim Alazhari University, Khartoum, Sudan., López-Jaramillo P; Universidad de Santander (UDES), Bucaramanga, Santander, Colombia., Grinvalds A; Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada., Temizhan A; Clinic of Cardiology, University of Health Science, Ankara City Hospital, Ankara, Türkiye., Hage C; Karolinska Institutet, Department of Medicine, Cardiology Unit, Stockholm, Sweden.; Karolinska University Hospital, Heart and Vascular Theme, Heart Failure Section, Stockholm, Sweden., Lund LH; Karolinska Institutet, Department of Medicine, Cardiology Unit, Stockholm, Sweden.; Karolinska University Hospital, Heart and Vascular Theme, Heart Failure Section, Stockholm, Sweden., Kazmi K; Department of Cardiology, Aga Khan University, Karachi, Pakistan., Lanas F; Universidad de La Frontera, Temuco, Chile., Sharma SK; B P Koirala Institute of Health Sciences, Dharan, Nepal., Fox K; Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom., McMurray JJV; British Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom., Leong D; Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada., Dokainish H; Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada., Khetan A; Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada., Yonga G; University of Nairobi, Department of Clinical Medicine and Therapeutics, Nairobi, Nairobi City County, Kenya., Kragholm K; Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark., Wagdy Shaker K; Aswan Heart Center, Magdi Yacoub Foundation, Department of Cardiology, Aswan, Egypt., Mwita JC; University of Botswana, Internal Medicine, Gaborone, Botswana., Al-Mulla AA; Division of Cardiology, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates., Alla F; Bordeaux Population Health Research Center, Université de Bordeaux, Bordeaux, France., Damasceno A; Eduardo Mondlane University, Faculty of Medicine, Maputo, Mozambique., Silva-Cardoso J; Faculty of Medicine, University of Porto, Porto, Portugal.; São João University Hospital Centre, Porto, Portugal., Dans AL; University of the Philippines, Medicine, Quezon City, National Capital Region, Philippines., Sliwa K; Cape Heart Institute, University of Cape Town, Cape Town, South Africa., O'Donnell M; College of Medicine, Nursing, and Health Sciences, University of Galway, Galway, Ireland., Bazargani N; Dubai Hospital, Dubai, United Arab Emirates., Bayés-Genís A; Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, CIBERCV, Spain., McCready T; Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada., Probstfield J; University of Washington, Cardiology, Seattle., Yusuf S; Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada.
Jazyk:	angličtina
Zdroj:	JAMA [JAMA] 2023 May 16; Vol. 329 (19), pp. 1650-1661.
DOI:	10.1001/jama.2023.5942
Abstrakt:	Importance: Most epidemiological studies of heart failure (HF) have been conducted in high-income countries with limited comparable data from middle- or low-income countries. Objective: To examine differences in HF etiology, treatment, and outcomes between groups of countries at different levels of economic development. Design, Setting, and Participants: 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. Main Outcomes and Measures: HF cause, HF medication use, hospitalization, and death. Results: 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%) (P < .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. Conclusions and Relevance: 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.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu