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多民族东南亚队列中射血分数保留与降低的心力衰竭患者的特征及结局比较

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

作者信息

MacDonald Michael Ross, Wee Pang Ping, Cao Yan, Yang Dong Mei, Lee Sheldon, Tong Khim Leng, Leong Kui Toh Gerard

机构信息

Department of Cardiology, Changi General Hospital, Singapore, Singapore.

Department of Cardiology, Changi General Hospital, Singapore, Singapore.

出版信息

Am J Cardiol. 2016 Oct 15;118(8):1233-1238. doi: 10.1016/j.amjcard.2016.07.039. Epub 2016 Jul 29.

Abstract

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.

摘要

在亚洲人群中,比较射血分数保留的心力衰竭(HFpEF)和射血分数降低的心力衰竭(HFrEF)患者特征及预后的数据较少。我们旨在评估一个明确的东南亚HFpEF队列与HFrEF队列相比的患病率、临床特征及1年预后。我们对2009年至2013年从新加坡樟宜综合医院出院、初步诊断为心力衰竭的1978例患者进行了一项回顾性观察研究。约29%的出院患者为HFpEF。HFpEF患者更可能为女性、年龄较大且高血压患病率较高。两组间30天预后的绝对发生率无显著差异。HFrEF和HFpEF患者1年时的绝对死亡率相似,分别为17%和15%(p = 0.3)。多变量调整后,两组预后无差异。基线时房颤是HFpEF患者死亡或因心力衰竭住院的预测因素,但在HFrEF患者中并非如此(交互作用p = 0.003)。总之,在这项对东南亚明确心力衰竭人群的研究中,我们发现心力衰竭患者的临床特征与西方相似,队列间30天和1年的死亡率及发病率无显著差异。

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