心力衰竭创新领导力稳步运动（SMILE HF）注册研究的原理、设计与中期观察：一项针对急性心力衰竭患者的多中心前瞻性队列注册研究
Rationale, Design, and Interim Observations of the Steady Movement With Innovating Leadership for Heart Failure (SMILE HF) Registry: A Multicenter Prospective Cohort Registry for Patients With Acute Heart Failure.
作者信息
Choi Jah Yeon, Kim Mi-Na, Han Seongwoo, Lee Sunki, Park Myung Soo, Kong Min Gyu, Kim Sung-Hea, Kim Yong-Hyun, Jo Sang-Ho, Kim Sungeun, Choi Seonghoon, Jeon Jinsung, Lee Jieun, Battumur Byambakhand, Park Seong-Mi, Kim Eung Ju
机构信息
Department of Cardiology, Korea University Guro Hospital, Seoul, Korea.
Department of Cardiology, Korea University Anam Hospital, Seoul, Korea.
出版信息
Int J Heart Fail. 2024 Jul 11;6(3):129-136. doi: 10.36628/ijhf.2024.0014. eCollection 2024 Jul.
BACKGROUND AND OBJECTIVES
Heart failure (HF) is a leading cause of hospitalization and death worldwide. The Steady Movement with Innovating Leadership for Heart Failure (SMILE HF) aims to evaluate the clinical characteristics, management, hospital course, and long-term outcomes of patients hospitalized for acute HF in South Korea.
METHODS
This prospective, observational multicenter cohort study was conducted on consecutive patients hospitalized for acute HF in nine university hospitals since September 2019. Enrolment of 2000 patients should be completed in 2024, and follow-up is planned through 2025.
RESULTS
Interim analysis of 1,052 consecutive patients was performed to understand the baseline characteristics. The mean age was 69±15 years; 57.6% were male. The mean left ventricular ejection fraction was 39±15%. The prevalences of HF with reduced ejection fraction, HF with mildly reduced ejection fraction, and HF with preserved ejection fraction were 50.9%, 15.3%, and 29.2%. Ischemic cardiomyopathy (CMP) was the most common etiology (32%), followed by tachycardia-induced CMP (12.8%) and idiopathic dilated CMP (9.5%). The prescription rate of angiotensin-converting enzyme inhibitor/angiotensin receptor blockers/angiotensin receptor/neprilysin inhibitor, beta-blockers, spironolactone, and sodium-glucose cotransporter-2 inhibitors at discharge were 76.8%, 66.5%, 50.0%, and 17.5%, respectively. The post-discharge 90-day mortality and readmission rates due to HF aggravation were 2.0% and 6.4%, respectively. Our analysis reveals the current state of acute HF in South Korea.
CONCLUSIONS
Our interim analysis provides valuable insights into the clinical characteristics, management, and early outcomes of acute HF patients in South Korea, highlighting the current state and treatment patterns in this population.
背景与目的
心力衰竭（HF）是全球住院和死亡的主要原因。心力衰竭创新领导力稳步行动（SMILE HF）旨在评估韩国因急性心力衰竭住院患者的临床特征、管理、住院过程及长期预后。
方法
本前瞻性、观察性多中心队列研究自2019年9月起在9家大学医院对因急性心力衰竭连续住院的患者进行。计划在2024年完成2000例患者的入组，并持续随访至2025年。
结果
对1052例连续患者进行中期分析以了解基线特征。平均年龄为69±15岁；57.6%为男性。平均左心室射血分数为39±15%。射血分数降低的心力衰竭、射血分数轻度降低的心力衰竭和射血分数保留的心力衰竭的患病率分别为50.9%、15.3%和29.2%。缺血性心肌病（CMP）是最常见的病因（32%），其次是心动过速性心肌病（12.8%）和特发性扩张型心肌病（9.5%）。出院时血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂/血管紧张素受体/脑啡肽酶抑制剂、β受体阻滞剂、螺内酯和钠-葡萄糖协同转运蛋白2抑制剂的处方率分别为76.8%、66.5%、50.0%和17.5%。出院后90天因心力衰竭加重导致的死亡率和再入院率分别为2.0%和6.4%。我们的分析揭示了韩国急性心力衰竭患者的现状。
结论
我们的中期分析为韩国急性心力衰竭患者的临床特征、管理及早期预后提供了有价值的见解，突出了该人群的现状和治疗模式。
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