Temporal Trends in Clinical Characteristics, Management and Prognosis of Patients With Symptomatic Heart Failure in Japan – Report From the CHART Studies –
| Autor: | Ryoichi Ushigome, Takeshi Yamauchi, Hiroaki Shimokawa, Kanako Tsuji, Shintaro Kasahara, Masanobu Miura, Kotaro Nochioka, Yasuhiko Sakata, Jun Takahashi, Takuya Oikawa, Satoshi Miyata, Soichiro Tadaki, Ruri Abe, Kenjiro Sato, Takeo Onose |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.drug_class Comorbidity Kaplan-Meier Estimate Ventricular Function Left Japan Risk Factors Internal medicine Diabetes mellitus Prevalence medicine Humans Registries Beta blocker Aged Proportional Hazards Models Heart Failure Ejection fraction Proportional hazards model business.industry Incidence Hazard ratio Cardiovascular Agents Stroke Volume General Medicine Brain natriuretic peptide medicine.disease Treatment Outcome Heart failure Cardiology Female Medical emergency Cardiology and Cardiovascular Medicine business |
| Zdroj: | Circulation Journal. 79:2396-2407 |
| ISSN: | 1347-4820 1346-9843 |
| DOI: | 10.1253/circj.cj-15-0514 |
| Popis: | Temporal trends in clinical characteristics, management and prognosis of patients with symptomatic heart failure (HF) remain to be elucidated in Japan.From the Chronic Heart Failure Analysis and Registry in the Tohoku District-1 (CHART-1; 2000-2005, n=1,278) and CHART-2 (2006-present, n=10,219) Studies, we enrolled 1,006 and 3,676 consecutive symptomatic stage C/D HF patients, respectively. As compared with the patients in the CHART-1 Study, those in the CHART-2 Study had similar age and sex prevalence, and were characterized by lower brain natriuretic peptide, higher prevalence of preserved left ventricular ejection fraction (LVEF) and higher prevalence of hypertension, diabetes mellitus and ischemic heart disease (IHD), particularly IHD with LVEF ≥50%. From CHART-1 to CHART-2, use of renin-angiotensin system inhibitors, β-blockers and aldosterone antagonists was significantly increased, while that of loop diuretics and digitalis was decreased. Three-year incidences of all-cause death (24 vs. 15%; adjusted hazard ratio [adjHR], 0.73; P0.001), cardiovascular death (17 vs. 7%; adjHR, 0.38; P0.001) and hospitalization for HF (30 vs. 17%; adjHR, 0.51; P0.001) were all significantly decreased from CHART-1 to CHART-2. In the CHART-2 Study, use of β-blockers was associated with improved prognosis in patients with LVEF50%, while that of statins was associated with improved prognosis in those with LVEF ≥50%.Along with implementation of evidence-based medications, the prognosis of HF patients has been improved in Japan. (clinicaltrials.gov identifier: NCT00418041) |
| Databáze: | OpenAIRE |
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