Comparison of Characteristics and Outcomes of Heart Failure Patients With Preserved Versus Reduced Ejection Fraction in a Multiethnic Southeast Asian Cohort

• Published in: The American journal of cardiology 2016-10, Vol.118 (8), p.1233-1238
• Main Authors: MacDonald, Michael Ross, Wee, Pang Ping, Cao, Yan, Yang, Dong Mei, Lee, Sheldon, Tong, Khim Leng, Leong, Kui Toh Gerard
• Format: Article
• Language: English
• Subjects: Age; Aged; Aged, 80 and over; Asia, Southeastern; Asian Continental Ancestry Group; Atrial Fibrillation - epidemiology; Blood pressure; Cardiac arrhythmia; Cardiology; Cause of Death; Cohort Studies; Comorbidity; Demographics; Diabetes; Dyspnea; Echocardiography; Ethnicity; Female; Fractions; Heart attacks; Heart failure; Heart Failure - blood; Heart Failure - diagnostic imaging; Heart Failure - epidemiology; Heart Failure - physiopathology; Hospitalization; Hospitalization - statistics & numerical data; Hospitals; Humans; Hypertension; Hypertension - epidemiology; Male; Middle Aged; Mortality; Multivariate Analysis; Natriuretic Peptide, Brain - blood; Patients; Peptide Fragments - blood; Population; Prognosis; Retrospective Studies; Sex Factors; Singapore; Stroke Volume
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2016.07.039

There are few data comparing the patient characteristics and outcomes of heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced EF (HFrEF) in Asian cohorts. We aimed to evaluate the prevalence, clinical characteristics, and 1-year outcomes of a well-defined Southeast Asian HFpEF cohort in comparison to an HFrEF cohort. We conducted a retrospective observational study of 1,978 patients discharged from Changi General Hospital, Singapore with a primary diagnosis of HF from 2009 to 2013. About 29% of discharges had HFpEF. Patients with HFpEF were more likely to be women, older age, and have a higher prevalence of hypertension. There were no significant differences in the absolute rates of 30-day outcomes between the 2 groups. The absolute rate of death at 1 year was similar in HFrEF and HFpEF at 17% and 15%, respectively (p = 0.3). After multivariate adjustment, there was no difference in the outcomes of the 2 groups. Atrial fibrillation at baseline was a predictor of death or HF hospitalization in HFpEF but not HFrEF (interaction p = 0.003). In conclusion, in this study of a Southeast Asian population with well-defined HF, we found that the clinical profile of patients with HF was similar to that in the West and 30-day and 1-year mortality and morbidity were not significantly different between cohorts.