Cohort study
Global Variations in Heart Failure Etiology, Management, and Outcomes
- Prospective multinational registry study
- 40 countries
Authors' conclusion
This study of HF patients from 40 different countries and derived from 4 different economic levels demonstrated differences in HF etiologies, management, and outcomes.
Study context
- Population
- Patients with heart failure (HF) in 40 high-, upper-middle-, lower-middle- and low-income countries
- Participants
- 23,341 patients · 40 countries
- Exposure
- Countries by economic level: high-income vs upper-middle-, lower-middle- and low-income
- Outcome
- HF cause, HF medication use, hospitalization and death
- Follow-up
- Median 2.0 years
Main finding
As reported in the abstract
Age- and sex-standardized mortality per 100 person-years
Observational data: associations, not effects.
Further findings
HFrEF on β-blocker + renin-angiotensin system inhibitor + MRA
30-day case-fatality after first hospital admission
Ratio
| Outcome | High-income | Upper-middle-income | Lower-middle-income | Low-income |
|---|---|---|---|---|
| Ratio of hospitalization to death rates | 3.8 | 2.4 | 1.1 | 0.6 |
- HFrEF on β-blocker + renin-angiotensin system inhibitor + MRA: P < .001
- 30-day case-fatality after first hospital admission: adjusted for patient characteristics and long-term HF therapies
HF cause (all participants)
- Ischemic heart disease
- 38.1%
- Hypertension
- 20.2%
30-day case-fatality after first hospital admission
- Adjusted risk of death within 30 days of first admission 3- to 5-fold higher in lower-middle- and low-income vs high-income countries
Original publication
Global Variations in Heart Failure Etiology, Management, and Outcomes. JAMA. Published 16 May 2023. doi:10.1001/jama.2023.5942
Summarised from the published abstract; every number is checked against it