TY - JOUR
T1 - In-Hospital and Three-Year Outcomes of Heart Failure Patients in South India
T2 - The Trivandrum Heart Failure Registry
AU - Sanjay, Ganapathi
AU - Jeemon, Panniyammakal
AU - Agarwal, Anubha
AU - Viswanathan, Sunitha
AU - Sreedharan, Madhu
AU - Vijayaraghavan, Govindan
AU - Bahuleyan, Charantharayil Gopalan
AU - Biju, R.
AU - Nair, Tiny
AU - Prathapkumar, N.
AU - Krishnakumar, G.
AU - Rajalekshmi, N.
AU - Suresh, Krishnan
AU - Park, Lawrence P.
AU - Huffman, Mark Daniel
AU - Harikrishnan, Sivadasanpillai
N1 - Funding Information:
The design of the Trivandrum Heart Failure Registry (THFR) has been described previously. 7 Briefly, THFR is a prospective hospital-based registry of participants with HF funded by the Indian Council for Medical Research. All 18 hospitals treating patients with HF in the district of Trivandrum in Kerala, India, participated in the registry. Patients with HF as defined by the European Society of Heart Failure were consecutively screened for enrollment in THFR from January to December 2013. 8 Participants ≥18 years of age and citizens of India were eligible for inclusion in the study. Patients with septicemia-related HF as determined by the local hospital investigator were excluded from the registry. Participants with left ventricular ejection fraction (LVEF) <45% were defined to have HF with reduced ejection fraction (HFrEF), and participants with LVEF ≥45% were defined as HF with preserved ejection fraction (HFpEF). A total of 1254 participants were assessed, and 1205 participants agreed to participate in THFR (Supplemental Fig. 1).
Funding Information:
M.D.H. receives funding from the World Heart Federation to serve as its senior program advisor for the Emerging Leaders program, which is supported by Boehringer Ingelheim and Novartis with previous support from BUPA and Astra Zeneca. M.D.H. also receives support from the American Heart Association, Verily, and Astra Zeneca for work unrelated to this research.
Publisher Copyright:
© 2018 Elsevier Inc.
PY - 2018/12
Y1 - 2018/12
N2 - Background: Long-term data on outcomes of participants hospitalized with heart failure (HF) from low- and middle-income countries are limited. Methods and Results: In the Trivandrum Heart Failure Registry (THFR) in 2013, 1205 participants from 18 hospitals in Trivandrum, India, were enrolled. Data were collected on demographics, clinical presentation, treatment, and outcomes. We performed survival analyses, compared groups and evaluated the association between heart failure (HF) type and mortality, adjusting for covariates that predicted mortality in a global HF risk score. The mean (standard deviation) age of participants was 61.2 (13.7) years. Ischemic heart disease was the most common cause (72%). The in-hospital mortality rate was higher for participants with HF with reduced ejection fraction (HFrEF; 9.7%) compared with those with HF with preserved ejection fraction (HFpEF; 4.8%; P =.003). After 3 years, 540 (44.8%) participants had died. The all-cause mortality rate was lower for participants with HFpEF (40.8%) compared with HFrEF (46.2%; P =.049). In multivariable models, older age (hazard ratio [HR] 1.24 per decade, 95% confidence interval [CI] 1.15-1.33), New York Heart Association functional class IV symptoms (HR 2.80, 95% CI 1.43-5.48), and higher serum creatinine (HR 1.12 per mg/dL, 95% CI 1.04-1.22) were associated with all-cause mortality. Conclusions: Participants with HF in the THFR have high 3-year all-cause mortality. Targeted hospital-based quality improvement initiatives are needed to improve survival during and after hospitalization for HF.
AB - Background: Long-term data on outcomes of participants hospitalized with heart failure (HF) from low- and middle-income countries are limited. Methods and Results: In the Trivandrum Heart Failure Registry (THFR) in 2013, 1205 participants from 18 hospitals in Trivandrum, India, were enrolled. Data were collected on demographics, clinical presentation, treatment, and outcomes. We performed survival analyses, compared groups and evaluated the association between heart failure (HF) type and mortality, adjusting for covariates that predicted mortality in a global HF risk score. The mean (standard deviation) age of participants was 61.2 (13.7) years. Ischemic heart disease was the most common cause (72%). The in-hospital mortality rate was higher for participants with HF with reduced ejection fraction (HFrEF; 9.7%) compared with those with HF with preserved ejection fraction (HFpEF; 4.8%; P =.003). After 3 years, 540 (44.8%) participants had died. The all-cause mortality rate was lower for participants with HFpEF (40.8%) compared with HFrEF (46.2%; P =.049). In multivariable models, older age (hazard ratio [HR] 1.24 per decade, 95% confidence interval [CI] 1.15-1.33), New York Heart Association functional class IV symptoms (HR 2.80, 95% CI 1.43-5.48), and higher serum creatinine (HR 1.12 per mg/dL, 95% CI 1.04-1.22) were associated with all-cause mortality. Conclusions: Participants with HF in the THFR have high 3-year all-cause mortality. Targeted hospital-based quality improvement initiatives are needed to improve survival during and after hospitalization for HF.
KW - Heart failure
KW - India
KW - registry
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U2 - 10.1016/j.cardfail.2018.05.007
DO - 10.1016/j.cardfail.2018.05.007
M3 - Article
C2 - 29885494
AN - SCOPUS:85050663958
SN - 1071-9164
VL - 24
SP - 842
EP - 848
JO - Journal of Cardiac Failure
JF - Journal of Cardiac Failure
IS - 12
ER -