Heart failure & cardiomyopathies
Temporal comparison of clinical practice and outcomes in heart failure: the JROADHF and JROADHF-NEXT studies
Authors' conclusion
Long-term outcomes of patients with HF improved between 2013 and 2019-21. Guideline-recommended therapy was associated with survival benefit, whereas marked reduction in HF readmission rates coincided with broader changes in post-discharge care and healthcare system.
Study context
- Population
- Patients with heart failure (HF) in two large-scale Japanese HF registries2,972 per cohort after matching
- Participants
- 4,016 vs 13,238
- Exposure
- 2019-21 cohort vs 2013 cohort
- 2019-21n = 4,016
- 2013n = 13,238reference
- Outcome
- 1-year mortality and HF readmission
- Follow-up
- 1 year
Methodological detailscohort study, propensity-score matched (1:1), multicentre registries
- Cohort study
- Propensity-score matched (1:1)
- Multicentre registries
Main finding
As reported in the abstract
Reduction
26.7%
P < 0.001
1-year mortality
Reduction
52.1%
P < 0.001
HF readmission rate
Observational data: associations, not effects.
Further findings
Guideline-recommended therapy after matching · matched cohort
RAS inhibitors
Beta-blockers
MRA
Cardiac rehabilitation
Nutritional guidance
Factors associated with improved mortality
- RAS inhibitors, HR (95% CI .64-.80), P < .001
- .71
- Beta-blockers, HR (95% CI .75-.96), P = .012
- .85
- Nutritional guidance, HR (95% CI .64-.89), P = .001
- .76
Predictor of HF readmission: cohort effect (strongest predictor)
- Cohort effect, subdistribution HR (95% CI .43-.57), P < .001
- .49
Original publication
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