What is the clinical evidence from this study?

Study design: Observational. Population: heart failure with preserved ejection fraction (HFpEF) (n=41708). Primary outcome: clinical outcomes (hospitalization for HF and cardiovascular death).

August 23, 2022

Clinical characteristics and 1‐year outcomes in hospitalized patients with heart failure with preserved ejection fraction: results from the China Cardiovascular Association Database‐Heart Failure Center Registry

Key Result

Hospitalized patients with HFpEF in China demonstrated a 1-year clinical outcome rate of 16.4%, driven by a 13.6% rate of heart failure hospitalization and a 3.1% rate of cardiovascular death.

Study Design

Type

Observational (n=41,708)

Multicenter

Yes

Structured PICO

Population

41,708 hospitalized patients with heart failure with preserved ejection fraction (HFpEF) from 481 secondary and tertiary hospitals across 31 provinces of mainland China, mean age 72.2 years, 49.3% female.

Outcome

1-year clinical outcomes (composite of hospitalization for HF [HHF] and cardiovascular [CV] death)composite

Hospitalized HFpEF patients in China have a high comorbid burden and a 16.4% 1-year risk of HHF or CV death, highlighting the need for improved management.

Abstract

AIM: We aimed to evaluate clinical characteristics and 1-year outcomes in hospitalized patients with heart failure with preserved ejection fraction (HFpEF) from China. Factors associated with outcomes (hospitalization for HF HHF and cardiovascular CV death) were assessed. METHOD AND RESULTS: Data were from the China Cardiovascular Association (CCA) Database-HF Center Registry. Between January 2017 and June 2021, 41 708 hospitalized HFpEF patients with 1-year follow-up from 481 CCA Database-HF Center certified secondary and tertiary hospitals across overall 31 provinces of mainland China were included in this study. Of study participants (mean age 72.2 years, 49.3% female), 18.2% had HHF in prior 1 year and 55.8% had New York Heart Association class III/IV. Median left ventricular ejection fraction was 59%. Ischaemia (26.6%), infection (14.4%) and arrhythmia (10.5%) were the three most common precipitating factors for index HHF. Nearly 67.4% had ≥3 comorbidities. Hypertension (65.2%), coronary heart disease (60.3%) and atrial fibrillation (41.2%) were the three most common comorbidities. Device and medication therapy non-compliance with current HF guideline recommendation was observed. The 1-year rate of clinical outcomes was 16.4%, the 1-year rate of HHF was 13.6% and CV death was 3.1%. Factors associated with clinical outcomes included HHF in prior 1 year, serum level of sodium 1800 pg/ml. CONCLUSION: Patients with HFpEF from China were characterized by high comorbid burden and high 1-year risk of HHF and CV death. Immediate efforts are needed to improve HFpEF management in China.

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