Intensive and Cardiac Care Unit, Nippon Medical School, Tokyo, Japan.
Am Heart J. 2010 Jun;159(6):949-955.e1. doi: 10.1016/j.ahj.2010.03.019.
Acute heart failure syndromes (AHFS) are likely to increase in the future, and the high readmission rate of patients with AHFS is an important issue in Western countries. However, there are very few published epidemiological studies on AHFS in the Asia Pacific region. Because AHFS are heterogeneous, the characteristics, clinical profile, and management of AHFS should be clarified in an epidemiological study. The acute decompensated heart failure syndromes (ATTEND) registry is a prospective, observational, multicenter cohort study being performed in Japan and is the first epidemiological study of AHFS in the Asia Pacific region. This study is designed to investigate several aspects of AHFS as follows: (1) the registry allows patient-based data collection for precise evaluation of patient characteristics and short-term outcomes, including the readmission rate; (2) confirmation of clinical assessments can be performed, and new clinical assessments can be created; and (3) feedback allows the modification of guidelines for clinical management. The present report describes the clinical characteristics of patients with AHFS in Japan based on the preliminary data collected in this study, and the similarities and differences in characteristics of these patients compared with those in Western countries. Although most of the patient characteristics did not differ from those reported in Western studies, there are some unique findings in this study, including a high rate of treatment with carperitide (69.4%) and angiotensin II receptor blockers (53.9%) at discharge and a longer hospital stay (median 21 days). The ATTEND registry is designed to provide valuable information to clarify the characteristics of patients with AHFS to improve their management.
急性心力衰竭综合征(AHFS)在未来可能会增加,AHFS 患者的高再入院率是西方国家的一个重要问题。然而,在亚太地区,关于 AHFS 的发表的流行病学研究很少。由于 AHFS 具有异质性,因此在流行病学研究中应明确 AHFS 的特征、临床特征和管理。急性失代偿性心力衰竭综合征(ATTEND)登记处是一项在日本进行的前瞻性、观察性、多中心队列研究,是亚太地区首个关于 AHFS 的流行病学研究。这项研究旨在调查 AHFS 的几个方面,如下所示:(1)登记处允许基于患者的数据收集,以便对患者特征和短期结局(包括再入院率)进行精确评估;(2)可以进行临床评估的确认,并创建新的临床评估;以及(3)反馈允许对临床管理指南进行修改。本报告根据该研究初步收集的数据描述了日本 AHFS 患者的临床特征,并比较了这些患者与西方国家患者的特征的相似性和差异。尽管大多数患者特征与西方研究报告的特征没有差异,但该研究中也有一些独特的发现,包括出院时卡培他滨(69.4%)和血管紧张素 II 受体阻滞剂(53.9%)的使用率较高以及住院时间较长(中位数为 21 天)。ATTEND 登记处旨在提供有价值的信息,以阐明 AHFS 患者的特征,从而改善其管理。