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Global Perspectives in Hospitalized Heart Failure: Regional and Ethnic Variation in Patient Characteristics, Management, and Outcomes

  • Epidemiology of Heart Failure (CSP Lam, Section Editor)
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Abstract

Heart failure (HF) is a public health problem of global proportions afflicting more than 25 million patients worldwide. Despite stable or declining per capita hospitalization rates in the USA and several European countries, there are over one million hospitalizations for HF annually in the USA, with similar numbers in Europe, accounting for 6.5 million hospital days and the majority of the approximately $40 billion spent each year on HF-related care. Moreover, clinical trial data suggest that post-discharge survival and readmissions have largely remained unchanged. Thus, understanding geographic and ethnic variations in HF is essential to formulating public policy at the local, national, regional, and international levels and setting the agenda for basic, translational, and clinical research endeavors. This paper aims to describe regional and ethnic variations in patient characteristics, management, and outcomes in hospitalized HF.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, et al. Executive summary: heart disease and stroke statistics—2014 update: a report from the American Heart Association. Circulation. 2014;129(3):399–410. doi:10.1161/01.cir.0000442015.53336.12.

    Article  PubMed  Google Scholar 

  2. Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, et al. Heart disease and stroke statistics—2014 update: a report from the American Heart Association. Circulation. 2014;129(3):e28–292. doi:10.1161/01.cir.0000441139.02102.80.

    Article  PubMed  Google Scholar 

  3. Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB, et al. Executive summary: heart disease and stroke statistics—2012 update: a report from the American Heart Association. Circulation. 2012;125(1):188–97. doi:10.1161/CIR.0b013e3182456d46.

    Article  PubMed  Google Scholar 

  4. Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB, et al. Heart disease and stroke statistics—2012 update: a report from the American Heart Association. Circulation. 2012;125(1):e2–220. doi:10.1161/CIR.0b013e31823ac046.

    Article  PubMed  Google Scholar 

  5. Heidenreich PA, Albert NM, Allen LA, Bluemke DA, Butler J, Fonarow GC, et al. Forecasting the Impact of Heart Failure in the United States: a policy statement from the American Heart Association. Circ Heart Fail. 2013. doi:10.1161/HHF.0b013e318291329a. This article projects estimates of the future burden of HF in the U.S.

    Google Scholar 

  6. Dickstein K, Cohen-Solal A, Filippatos G, McMurray JJ, Ponikowski P, Poole-Wilson PA, et al. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the Task Force for the diagnosis and treatment of acute and chronic heart failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM). Eur J Heart Fail. 2008;10(10):933–89.

    Article  PubMed  Google Scholar 

  7. Dickstein K, Cohen-Solal A, Filippatos G, McMurray JJ, Ponikowski P, Poole-Wilson PA, et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM). Eur Heart J. 2008;29(19):2388–442.

    Article  CAS  PubMed  Google Scholar 

  8. Mosterd A, Hoes AW. Clinical epidemiology of heart failure. Heart. 2007;93(9):1137–46. doi:10.1136/hrt.2003.025270.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Gheorghiade M, Ambrosy A. Heart failure in 2010: one step forward, two steps back. Nat Rev Cardiol. 2011;8(2):72–3. doi:10.1038/nrcardio.2010.205.

    Article  PubMed  Google Scholar 

  10. Gheorghiade M, Peterson ED. Improving postdischarge outcomes in patients hospitalized for acute heart failure syndromes. JAMA J Am Med Assoc. 2011;305(23):2456–7. doi:10.1001/jama.2011.836.

    Article  CAS  Google Scholar 

  11. Gheorghiade M, Braunwald E. A proposed model for initial assessment and management of acute heart failure syndromes. JAMA J Am Med Assoc. 2011;305(16):1702–3. doi:10.1001/jama.2011.515.

    Article  CAS  Google Scholar 

  12. Blecker S, Paul M, Taksler G, Ogedegbe G, Katz S. Heart failure associated hospitalizations in the United States. J Am Coll Cardiol. 2013;61(12):1259–67. doi:10.1016/j.jacc.2012.12.038.

    Article  PubMed  Google Scholar 

  13. Alla F, Zannad F, Filippatos G. Epidemiology of acute heart failure syndromes. Heart Fail Rev. 2007;12(2):91–5. doi:10.1007/s10741-007-9009-2.

    Article  PubMed  Google Scholar 

  14. Zannad F, Agrinier N, Alla F. Heart failure burden and therapy. Europace Eur Pacing Arrhythmias Card Electrophysiol J Work Groups Card Pacing Arrhythmias Card Cell Electrophysiol Eur Soc Cardiol. 2009;11 Suppl 5:v1–9. doi:10.1093/europace/eup304.

    Article  Google Scholar 

  15. Schaufelberger M, Swedberg K, Koster M, Rosen M, Rosengren A. Decreasing one-year mortality and hospitalization rates for heart failure in Sweden; data from the Swedish Hospital Discharge Registry 1988 to 2000. Eur Heart J. 2004;25(4):300–7. doi:10.1016/j.ehj.2003.12.012.

    Article  PubMed  Google Scholar 

  16. Stewart S, MacIntyre K, MacLeod MM, Bailey AE, Capewell S, McMurray JJ. Trends in hospitalization for heart failure in Scotland, 1990–1996. An epidemic that has reached its peak? Eur Heart J. 2001;22(3):209–17.

    Article  CAS  PubMed  Google Scholar 

  17. Mosterd A, Reitsma JB, Grobbee DE. Angiotensin converting enzyme inhibition and hospitalisation rates for heart failure in the Netherlands, 1980 to 1999: the end of an epidemic? Heart. 2002;87(1):75–6.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  18. Gheorghiade M, Bohm M, Greene SJ, Fonarow GC, Lewis EF, Zannad F, et al. Effect of aliskiren on postdischarge mortality and heart failure readmissions among patients hospitalized for heart failure: the ASTRONAUT randomized trial. JAMA J Am Med Assoc. 2013;309(11):1125–35. doi:10.1001/jama.2013.1954.

    Article  CAS  Google Scholar 

  19. Konstam MA, Gheorghiade M, Burnett Jr JC, Grinfeld L, Maggioni AP, Swedberg K, et al. Effects of oral tolvaptan in patients hospitalized for worsening heart failure: the EVEREST Outcome Trial. JAMA J Am Med Assoc. 2007;297(12):1319–31. doi:10.1001/jama.297.12.1319.

    Article  CAS  Google Scholar 

  20. Ambrosy AP, Fonarow GC, Butler J, Chioncel O, Greene SJ, Vaduganathan M, et al. The global health and economic burden of hospitalizations for heart failure: lessons learned from hospitalized heart failure registries. J Am Coll Cardiol. 2014;63(12):1123–33. doi:10.1016/j.jacc.2013.11.053. A state-of-the-art review explores the socioeconomic burden of HF worldwide as well as providing a conceptual framework for a global hospital-based registry.

    Article  PubMed  Google Scholar 

  21. Mentz RJ, Kaski JC, Dan GA, Goldstein S, Stockbridge N, Alonso-Garcia A, et al. Implications of geographical variation on clinical outcomes of cardiovascular trials. Am Heart J. 2012;164(3):303–12. doi:10.1016/j.ahj.2012.06.006. A perspective piece discussed the impact of geographic variation in cardiovascular disease on the design and conduct of global clinical trials.

    Article  PubMed  Google Scholar 

  22. Adams Jr KF, Fonarow GC, Emerman CL, LeJemtel TH, Costanzo MR, Abraham WT, et al. Characteristics and outcomes of patients hospitalized for heart failure in the United States: rationale, design, and preliminary observations from the first 100,000 cases in the Acute Decompensated Heart Failure National Registry (ADHERE). Am Heart J. 2005;149(2):209–16. doi:10.1016/j.ahj.2004.08.005.

    Article  PubMed  Google Scholar 

  23. Gheorghiade M, Abraham WT, Albert NM, Greenberg BH, O’Connor CM, She L, et al. Systolic blood pressure at admission, clinical characteristics, and outcomes in patients hospitalized with acute heart failure. JAMA J Am Med Assoc. 2006;296(18):2217–26. doi:10.1001/jama.296.18.2217.

    Article  CAS  Google Scholar 

  24. Steinberg BA, Zhao X, Heidenreich PA, Peterson ED, Bhatt DL, Cannon CP, et al. Trends in patients hospitalized with heart failure and preserved left ventricular ejection fraction: prevalence, therapies, and outcomes. Circulation. 2012;126(1):65–75. doi:10.1161/CIRCULATIONAHA.111.080770.

    Article  PubMed  Google Scholar 

  25. Nieminen MS, Brutsaert D, Dickstein K, Drexler H, Follath F, Harjola VP, et al. EuroHeart Failure Survey II (EHFS II): a survey on hospitalized acute heart failure patients: description of population. Eur Heart J. 2006;27(22):2725–36. doi:10.1093/eurheartj/ehl193.

    Article  PubMed  Google Scholar 

  26. Maggioni AP, Dahlstrom U, Filippatos G, Chioncel O, Leiro MC, Drozdz J, et al. EURObservational Research Programme: the Heart Failure Pilot Survey (ESC-HF Pilot). Eur J Heart Fail. 2010;12(10):1076–84. doi:10.1093/eurjhf/hfq154.

    Article  PubMed  Google Scholar 

  27. Oliva F, Mortara A, Cacciatore G, Chinaglia A, Di Lenarda A, Gorini M, et al. Acute heart failure patient profiles, management and in-hospital outcome: results of the Italian Registry on Heart Failure Outcome. Eur J Heart Fail. 2012;14(11):1208–17. doi:10.1093/eurjhf/hfs117.

    Article  PubMed  Google Scholar 

  28. Zannad F, Mebazaa A, Juilliere Y, Cohen-Solal A, Guize L, Alla F, et al. Clinical profile, contemporary management and one-year mortality in patients with severe acute heart failure syndromes: the EFICA study. Eur J Heart Fail. 2006;8(7):697–705. doi:10.1016/j.ejheart.2006.01.001.

    Article  PubMed  Google Scholar 

  29. Chioncel O, Vinereanu D, Datcu M, Ionescu DD, Capalneanu R, Brukner I, et al. The Romanian Acute Heart Failure Syndromes (RO-AHFS) registry. Am Heart J. 2011;162(1):142–53.e1. doi:10.1016/j.ahj.2011.03.033.

    Article  PubMed  Google Scholar 

  30. Spinar J, Parenica J, Vitovec J, Widimsky P, Linhart A, Fedorco M, et al. Baseline characteristics and hospital mortality in the Acute Heart Failure Database (AHEAD) main registry. Crit Care. 2011;15(6):R291. doi:10.1186/cc10584.

    Article  PubMed Central  PubMed  Google Scholar 

  31. Sato N, Kajimoto K, Keida T, Mizuno M, Minami Y, Yumino D, et al. Clinical features and outcome in hospitalized heart failure in Japan (from the ATTEND Registry). Circ J Off J Jpn Circ Soc. 2013;77(4):944–51.

    CAS  Google Scholar 

  32. Atherton JJ, Hayward CS, Wan Ahmad WA, Kwok B, Jorge J, Hernandez AF, et al. Patient characteristics from a regional multicenter database of acute decompensated heart failure in Asia Pacific (ADHERE International-Asia Pacific). J Card Fail. 2012;18(1):82–8. doi:10.1016/j.cardfail.2011.09.003.

    Article  PubMed  Google Scholar 

  33. Damasceno A, Mayosi BM, Sani M, Ogah OS, Mondo C, Ojji D, et al. The causes, treatment, and outcome of acute heart failure in 1006 Africans from 9 countries. Arch Intern Med. 2012;172(18):1386–94. doi:10.1001/archinternmed.2012.3310.

    Article  CAS  PubMed  Google Scholar 

  34. Follath F, Yilmaz MB, Delgado JF, Parissis JT, Porcher R, Gayat E, et al. Clinical presentation, management and outcomes in the Acute Heart Failure Global Survey of Standard Treatment (ALARM-HF). Intensive Care Med. 2011;37(4):619–26. doi:10.1007/s00134-010-2113-0.

    Article  CAS  PubMed  Google Scholar 

  35. Blair JE, Zannad F, Konstam MA, Cook T, Traver B, Burnett Jr JC, et al. Continental differences in clinical characteristics, management, and outcomes in patients hospitalized with worsening heart failure results from the EVEREST (Efficacy of Vasopressin Antagonism in Heart Failure: Outcome Study with Tolvaptan) program. J Am Coll Cardiol. 2008;52(20):1640–8. doi:10.1016/j.jacc.2008.07.056. An original manuscript examining regional differences in patient characteristics, management, and outcomes in the EVEREST trial.

    Article  PubMed  Google Scholar 

  36. Mentz RJ, Cotter G, Cleland JG, Stevens SR, Chiswell K, Davison BA, et al. International differences in clinical characteristics, management, and outcomes in acute heart failure patients: better short-term outcomes in patients enrolled in Eastern Europe and Russia in the PROTECT trial. Eur J Heart Fail. 2014. doi:10.1002/ejhf.92. An original manuscript examining regional differences in patient characteristics, management, and outcomes in the PROTECT trial.

    Google Scholar 

  37. Cotter G, Cotter-Davison B, Ogah OS. The burden of heart failure in Africa. Eur J Heart Fail. 2013;15(8):829–31. doi:10.1093/eurjhf/hft073.

    Article  PubMed  Google Scholar 

  38. Ojji D, Stewart S, Ajayi S, Manmak M, Sliwa K. A predominance of hypertensive heart failure in the Abuja Heart Study cohort of urban Nigerians: a prospective clinical registry of 1515 de novo cases. Eur J Heart Fail. 2013;15(8):835–42. doi:10.1093/eurjhf/hft061.

    Article  PubMed  Google Scholar 

  39. Sliwa K, Wilkinson D, Hansen C, Ntyintyane L, Tibazarwa K, Becker A, et al. Spectrum of heart disease and risk factors in a black urban population in South Africa (the Heart of Soweto Study): a cohort study. Lancet. 2008;371(9616):915–22. doi:10.1016/S0140-6736(08)60417-1.

    Article  PubMed  Google Scholar 

  40. Hsich EM, Pina IL. Heart failure in women: a need for prospective data. J Am Coll Cardiol. 2009;54(6):491–8. doi:10.1016/j.jacc.2009.02.066.

    Article  PubMed  Google Scholar 

  41. Galvao M, Kalman J, DeMarco T, Fonarow GC, Galvin C, Ghali JK, et al. Gender differences in in-hospital management and outcomes in patients with decompensated heart failure: analysis from the Acute Decompensated Heart Failure National Registry (ADHERE). J Card Fail. 2006;12(2):100–7. doi:10.1016/j.cardfail.2005.09.005.

    Article  PubMed  Google Scholar 

  42. Hsich EM, Grau-Sepulveda MV, Hernandez AF, Peterson ED, Schwamm LH, Bhatt DL, et al. Sex differences in in-hospital mortality in acute decompensated heart failure with reduced and preserved ejection fraction. Am Heart J. 2012;163(3):430–7. doi:10.1016/j.ahj.2011.12.013. 7 e1-3.

    Article  PubMed  Google Scholar 

  43. Kamath SA, Drazner MH, Wynne J, Fonarow GC, Yancy CW. Characteristics and outcomes in African American patients with decompensated heart failure. Arch Intern Med. 2008;168(11):1152–8. doi:10.1001/archinte.168.11.1152.

    Article  PubMed  Google Scholar 

  44. Yancy CW, Abraham WT, Albert NM, Clare R, Stough WG, Gheorghiade M, et al. Quality of care of and outcomes for African Americans hospitalized with heart failure: findings from the OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure) registry. J Am Coll Cardiol. 2008;51(17):1675–84. doi:10.1016/j.jacc.2008.01.028.

    Article  PubMed  Google Scholar 

  45. Thomas KL, Hernandez AF, Dai D, Heidenreich P, Fonarow GC, Peterson ED, et al. Association of race/ethnicity with clinical risk factors, quality of care, and acute outcomes in patients hospitalized with heart failure. Am Heart J. 2011;161(4):746–54. doi:10.1016/j.ahj.2011.01.012. This analysis of the GWTG-HF registry describes racial and ethnic differences and quality of care and outcomes in the U.S.

    Article  PubMed  Google Scholar 

  46. Taylor AL, Ziesche S, Yancy C, Carson P, D’Agostino Jr R, Ferdinand K, et al. Combination of isosorbide dinitrate and hydralazine in blacks with heart failure. N Engl J Med. 2004;351(20):2049–57. doi:10.1056/NEJMoa042934.

    Article  CAS  PubMed  Google Scholar 

  47. Yancy CW, Fowler MB, Colucci WS, Gilbert EM, Bristow MR, Cohn JN, et al. Race and the response to adrenergic blockade with carvedilol in patients with chronic heart failure. N Engl J Med. 2001;344(18):1358–65. doi:10.1056/NEJM200105033441803.

    Article  CAS  PubMed  Google Scholar 

  48. Yancy CW, Lopatin M, Stevenson LW, De Marco T, Fonarow GC. Clinical presentation, management, and in-hospital outcomes of patients admitted with acute decompensated heart failure with preserved systolic function: a report from the Acute Decompensated Heart Failure National Registry (ADHERE) Database. J Am Coll Cardiol. 2006;47(1):76–84. doi:10.1016/j.jacc.2005.09.022.

    Article  PubMed  Google Scholar 

  49. Shah SJ, Gheorghiade M. Heart failure with preserved ejection fraction: treat now by treating comorbidities. JAMA J Am Med Assoc. 2008;300(4):431–3. doi:10.1001/jama.300.4.431.

    Article  CAS  Google Scholar 

  50. Fonarow GC, Stough WG, Abraham WT, Albert NM, Gheorghiade M, Greenberg BH, et al. Characteristics, treatments, and outcomes of patients with preserved systolic function hospitalized for heart failure: a report from the OPTIMIZE-HF Registry. J Am Coll Cardiol. 2007;50(8):768–77. doi:10.1016/j.jacc.2007.04.064.

    Article  PubMed  Google Scholar 

  51. Mentz RJ, Fiuzat M. Sleep-disordered breathing in patients with heart failure. Heart Fail Clin. 2014;10(2):243–50. doi:10.1016/j.hfc.2013.10.001.

    Article  PubMed  Google Scholar 

  52. Jiang W, Kuchibhatla M, Cuffe MS, Christopher EJ, Alexander JD, Clary GL, et al. Prognostic value of anxiety and depression in patients with chronic heart failure. Circulation. 2004;110(22):3452–6. doi:10.1161/01.CIR.0000148138.25157.F9.

    Article  CAS  PubMed  Google Scholar 

  53. Gheorghiade M, Follath F, Ponikowski P, Barsuk JH, Blair JE, Cleland JG, et al. Assessing and grading congestion in acute heart failure: a scientific statement from the acute heart failure committee of the heart failure association of the European Society of Cardiology and endorsed by the European Society of Intensive Care Medicine. Eur J Heart Fail. 2010;12(5):423–33. doi:10.1093/eurjhf/hfq045.

    Article  PubMed  Google Scholar 

  54. Mebazaa A, Pang PS, Tavares M, Collins SP, Storrow AB, Laribi S, et al. The impact of early standard therapy on dyspnoea in patients with acute heart failure: the URGENT-dyspnoea study. Eur Heart J. 2010;31(7):832–41. doi:10.1093/eurheartj/ehp458. An observational study addressing the impact of early standard therapy on dyspnea in patients presenting to emergency rooms with acute decompensated HF.

    Article  PubMed  Google Scholar 

  55. Pang PS, Tavares M, Collins SP, Cleland JG, Hollander J, Nieminen M, et al. Design and rationale of the URGENT Dyspnea study: an international, multicenter, prospective study. Am J Ther. 2008;15(4):299–303. doi:10.1097/MJT.0b013e31816b436e.

    Article  PubMed  Google Scholar 

  56. Nieminen MS, Bohm M, Cowie MR, Drexler H, Filippatos GS, Jondeau G, et al. Executive summary of the guidelines on the diagnosis and treatment of acute heart failure: the Task Force on Acute Heart Failure of the European Society of Cardiology. Eur Heart J. 2005;26(4):384–416. doi:10.1093/eurheartj/ehi044.

    Article  PubMed  Google Scholar 

  57. Gattis WA, O’Connor CM, Hasselblad V, Adams Jr KF, Kobrin I, Gheorghiade M. Usefulness of an elevated troponin-I in predicting clinical events in patients admitted with acute heart failure and acute coronary syndrome (from the RITZ-4 trial). Am J Cardiol. 2004;93(11):1436–7. doi:10.1016/j.amjcard.2004.02.051. A10.

    Article  CAS  PubMed  Google Scholar 

  58. Januzzi Jr JL, Filippatos G, Nieminen M, Gheorghiade M. Troponin elevation in patients with heart failure: on behalf of the third Universal Definition of Myocardial Infarction Global Task Force: Heart Failure Section. Eur Heart J. 2012;33(18):2265–71. doi:10.1093/eurheartj/ehs191.

    Article  CAS  PubMed  Google Scholar 

  59. Kociol RD, Pang PS, Gheorghiade M, Fonarow GC, O’Connor CM, Felker GM. Troponin elevation in heart failure prevalence, mechanisms, and clinical implications. J Am Coll Cardiol. 2010;56(14):1071–8. doi:10.1016/j.jacc.2010.06.016.

    Article  CAS  PubMed  Google Scholar 

  60. Weintraub NL, Collins SP, Pang PS, Levy PD, Anderson AS, Arslanian-Engoren C, et al. Acute heart failure syndromes: emergency department presentation, treatment, and disposition: current approaches and future aims: a scientific statement from the American Heart Association. Circulation. 2010;122(19):1975–96. doi:10.1161/CIR.0b013e3181f9a223.

    Article  PubMed  Google Scholar 

  61. Peacock WF, Braunwald E, Abraham W, Albert N, Burnett J, Christenson R, et al. National Heart, Lung, and Blood Institute working group on emergency department management of acute heart failure: research challenges and opportunities. J Am Coll Cardiol. 2010;56(5):343–51. doi:10.1016/j.jacc.2010.03.051.

    Article  PubMed  Google Scholar 

  62. Lindenfeld J, Albert NM, Boehmer JP, Collins SP, Ezekowitz JA, Givertz MM, et al. HFSA 2010 comprehensive heart failure practice guideline. J Card Fail. 2010;16(6):e1–194. doi:10.1016/j.cardfail.2010.04.004.

    Article  PubMed  Google Scholar 

  63. Yancy CW, Jessup M, Bozkurt B, Butler J, Casey Jr DE, Drazner MH, et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2013;128(16):e240–327. doi:10.1161/CIR.0b013e31829e8776.

    Article  PubMed  Google Scholar 

  64. McMurray JJ, Adamopoulos S, Anker SD, Auricchio A, Bohm M, Dickstein K, et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2012;33(14):1787–847.

    Article  PubMed  Google Scholar 

  65. Young JB, Abraham WT, Albert NM, Gattis Stough W, Gheorghiade M, Greenberg BH, et al. Relation of low hemoglobin and anemia to morbidity and mortality in patients hospitalized with heart failure (insight from the OPTIMIZE-HF registry). Am J Cardiol. 2008;101(2):223–30. doi:10.1016/j.amjcard.2007.07.067.

    Article  CAS  PubMed  Google Scholar 

  66. Gheorghiade M, Abraham WT, Albert NM, Gattis Stough W, Greenberg BH, O’Connor CM, et al. Relationship between admission serum sodium concentration and clinical outcomes in patients hospitalized for heart failure: an analysis from the OPTIMIZE-HF registry. Eur Heart J. 2007;28(8):980–8. doi:10.1093/eurheartj/ehl542.

    Article  CAS  PubMed  Google Scholar 

  67. Chioncel O, Ambrosy AP, Filipescu D, Bubenek S, Vinereanu D, Petris A, et al. Patterns of intensive care unit admissions in patients hospitalized for heart failure: insights from the RO-AHFS registry. J Cardiovasc Med (Hagerstown). 2014. doi:10.2459/JCM.0000000000000030. A post-hoc analysis of the RO-AHFS registry exploring patterns of care and outcomes in patients hospitalized for HF and admitted to the ICU/CCU.

    Google Scholar 

  68. Heywood JT, Fonarow GC, Costanzo MR, Mathur VS, Wigneswaran JR, Wynne J. High prevalence of renal dysfunction and its impact on outcome in 118,465 patients hospitalized with acute decompensated heart failure: a report from the ADHERE database. J Card Fail. 2007;13(6):422–30. doi:10.1016/j.cardfail.2007.03.011.

    Article  PubMed  Google Scholar 

  69. Collins SP, Pang PS, Lindsell CJ, Kyriacou DN, Storrow AB, Hollander JE, et al. International variations in the clinical, diagnostic, and treatment characteristics of emergency department patients with acute heart failure syndromes. Eur J Heart Fail. 2010;12(11):1253–60. doi:10.1093/eurjhf/hfq133. Global variation in clinical characteristics and management of patients presenting to the emergency room with acute decompensated HF.

    Article  PubMed Central  PubMed  Google Scholar 

  70. Wang NC, Maggioni AP, Konstam MA, Zannad F, Krasa HB, Burnett Jr JC, et al. Clinical implications of QRS duration in patients hospitalized with worsening heart failure and reduced left ventricular ejection fraction. JAMA J Am Med Assoc. 2008;299(22):2656–66. doi:10.1001/jama.299.22.2656.

    Article  CAS  Google Scholar 

  71. Shah AM, Shah SJ, Anand IS, Sweitzer NK, O’Meara E, Heitner JF, et al. Cardiac structure and function in heart failure with preserved ejection fraction: baseline findings from the echocardiographic study of the treatment of preserved cardiac function heart failure with an aldosterone antagonist trial. Circ Heart Fail. 2014;7(1):104–15. doi:10.1161/CIRCHEARTFAILURE.113.000887.

    Article  CAS  PubMed  Google Scholar 

  72. Vaduganathan M, Greene SJ, Ambrosy AP, Gheorghiade M, Butler J. The disconnect between phase II and phase III trials of drugs for heart failure. Nat Rev Cardiol. 2013;10(2):85–97. doi:10.1038/nrcardio.2012.181.

    Article  CAS  PubMed  Google Scholar 

  73. Abraham WT, Adams KF, Fonarow GC, Costanzo MR, Berkowitz RL, LeJemtel TH, et al. In-hospital mortality in patients with acute decompensated heart failure requiring intravenous vasoactive medications: an analysis from the Acute Decompensated Heart Failure National Registry (ADHERE). J Am Coll Cardiol. 2005;46(1):57–64. doi:10.1016/j.jacc.2005.03.051.

    Article  PubMed  Google Scholar 

  74. Shah MR, Hasselblad V, Stevenson LW, Binanay C, O’Connor CM, Sopko G, et al. Impact of the pulmonary artery catheter in critically ill patients: meta-analysis of randomized clinical trials. JAMA J Am Med Assoc. 2005;294(13):1664–70. doi:10.1001/jama.294.13.1664.

    Article  CAS  Google Scholar 

  75. Binanay C, Califf RM, Hasselblad V, O’Connor CM, Shah MR, Sopko G, et al. Evaluation study of congestive heart failure and pulmonary artery catheterization effectiveness: the ESCAPE trial. JAMA J Am Med Assoc. 2005;294(13):1625–33. doi:10.1001/jama.294.13.1625.

    Article  Google Scholar 

  76. Gattis WA, O’Connor CM, Gallup DS, Hasselblad V, Gheorghiade M. Predischarge initiation of carvedilol in patients hospitalized for decompensated heart failure: results of the Initiation Management Predischarge: Process for Assessment of Carvedilol Therapy in Heart Failure (IMPACT-HF) trial. J Am Coll Cardiol. 2004;43(9):1534–41. doi:10.1016/j.jacc.2003.12.040.

    Article  CAS  PubMed  Google Scholar 

  77. Gheorghiade M, Gattis WA, Lukas MA, O’Connor CM. Rationale and design of the Initiation Management Predischarge: Process for Assessment of Carvedilol Therapy for Heart Failure (IMPACT-HF) study. Am Heart J. 2003;145(2 Suppl):S60–1. doi:10.1067/mhj.2003.157.

    Article  CAS  PubMed  Google Scholar 

  78. Butler J, Arbogast PG, Daugherty J, Jain MK, Ray WA, Griffin MR. Outpatient utilization of angiotensin-converting enzyme inhibitors among heart failure patients after hospital discharge. J Am Coll Cardiol. 2004;43(11):2036–43. doi:10.1016/j.jacc.2004.01.041.

    Article  CAS  PubMed  Google Scholar 

  79. Pitt B, Zannad F, Remme WJ, Cody R, Castaigne A, Perez A, et al. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators. N Engl J Med. 1999;341(10):709–17. doi:10.1056/NEJM199909023411001.

    Article  CAS  PubMed  Google Scholar 

  80. Juurlink DN, Mamdani MM, Lee DS, Kopp A, Austin PC, Laupacis A, et al. Rates of hyperkalemia after publication of the Randomized Aldactone Evaluation Study. N Engl J Med. 2004;351(6):543–51. doi:10.1056/NEJMoa040135.

    Article  CAS  PubMed  Google Scholar 

  81. Ambrosy AP, Butler J, Ahmed A, Vaduganathan M, van Veldhuisen DJ, Colucci WS, et al. The use of digoxin in patients with worsening chronic heart failure: reconsidering an old drug to reduce hospital admissions. J Am Coll Cardiol. 2014;63(18):1823–32. doi:10.1016/j.jacc.2014.01.051.

    Article  CAS  PubMed  Google Scholar 

  82. Maggioni AP, Anker SD, Dahlstrom U, Filippatos G, Ponikowski P, Zannad F, et al. Are hospitalized or ambulatory patients with heart failure treated in accordance with European Society of Cardiology guidelines? Evidence from 12,440 patients of the ESC Heart Failure Long-Term Registry. Eur J Heart Fail. 2013;15(10):1173–84. doi:10.1093/eurjhf/hft134. This retrospective review of the long-term ESC HF registry examined the real rate of undertreatment of HF patients with evidence-based therapies after taking into account contraindications and intolerances.

    Article  CAS  PubMed  Google Scholar 

  83. Wang NC, Fonarow GC, Gheorghiade M. The potential application of electrophysiology diagnostics and therapeutics in acute heart failure syndromes. Heart Fail Rev. 2011;16(5):437–9. doi:10.1007/s10741-011-9247-1.

    Article  PubMed  Google Scholar 

  84. Wang NC, Bhattacharya S, Gheorghiade M. The potential role of cardiac resynchronization therapy in acute heart failure syndromes. Heart Fail Rev. 2011;16(5):481–90. doi:10.1007/s10741-011-9237-3.

    Article  PubMed  Google Scholar 

  85. Wang NC, Piccini JP, Gheorghiade M. Implantable cardioverter-defibrillator implementation in acute heart failure syndromes: unanswered questions. Heart Fail Rev. 2011;16(5):477–80. doi:10.1007/s10741-011-9243-5.

    Article  PubMed  Google Scholar 

  86. Maggioni AP, Dahlstrom U, Filippatos G, Chioncel O, Leiro MC, Drozdz J, et al. EURObservational Research Programme: regional differences and 1-year follow-up results of the Heart Failure Pilot Survey (ESC-HF Pilot). Eur J Heart Fail. 2013. doi:10.1093/eurjhf/hft050.

    Google Scholar 

  87. O’Connor CM, Miller AB, Blair JE, Konstam MA, Wedge P, Bahit MC, et al. Causes of death and rehospitalization in patients hospitalized with worsening heart failure and reduced left ventricular ejection fraction: results from Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study with Tolvaptan (EVEREST) program. Am Heart J. 2010;159(5):841–9.e1. doi:10.1016/j.ahj.2010.02.023. A post-hoc analysis of the EVEREST trial describing the mode of death and etiology of readmission in patients hospitalized for HF.

    Article  PubMed  Google Scholar 

  88. O’Connor CM, Fiuzat M, Swedberg K, Caron M, Koch B, Carson PE, et al. Influence of global region on outcomes in heart failure beta-blocker trials. J Am Coll Cardiol. 2011;58(9):915–22. doi:10.1016/j.jacc.2011.03.057.

    Article  PubMed  Google Scholar 

  89. Pitt B, Pfeffer MA, Assmann SF, Boineau R, Anand IS, Claggett B, et al. Spironolactone for heart failure with preserved ejection fraction. N Engl J Med. 2014;370(15):1383–92. doi:10.1056/NEJMoa1313731.

    Article  CAS  PubMed  Google Scholar 

  90. McMurray JJ, O’Connor C. Lessons from the TOPCAT trial. N Engl J Med. 2014;370(15):1453–4. doi:10.1056/NEJMe1401231.

    Article  CAS  PubMed  Google Scholar 

  91. Pitt B, Gheorghiade M. Geographic variation in heart failure trials: time for scepticism? Eur J Heart Fail. 2014;16(6):601–2. doi:10.1002/ejhf.112. A provocative editorial addressing the implications of geographic variation in patient characteristics, management, and outcomes on the design and conduct of global clinical trials.

    Article  PubMed  Google Scholar 

  92. Gheorghiade M, Vaduganathan M, Greene SJ, Mentz RJ, Adams Jr KF, Anker SD, et al. Site selection in global clinical trials in patients hospitalized for heart failure: perceived problems and potential solutions. Heart Fail Rev. 2012. doi:10.1007/s10741-012-9361-8.

    PubMed Central  Google Scholar 

  93. Butler J, Subacius H, Vaduganathan M, Fonarow GC, Ambrosy AP, Konstam MA, et al. Relationship between clinical trial site enrollment with participant characteristics, protocol completion, and outcomes: insights from the EVEREST (Efficacy of Vasopressin Antagonism in Heart Failure: Outcome Study with Tolvaptan) trial. J Am Coll Cardiol. 2013;61(5):571–9. doi:10.1016/j.jacc.2012.10.025.

    Article  PubMed  Google Scholar 

  94. Butler J, Fonarow GC, Gheorghiade M. Strategies and opportunities for drug development in heart failure. JAMA J Am Med Assoc. 2013;1–2. doi:10.1001/jama.2013.1063.

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Conflict of Interest

Andrew P. Ambrosy declares that he has no conflict of interest.

Mihai Gheorghiade has received compensation from Abbott Laboratories, Astellas, AstraZeneca, Bayer Schering Pharma, Bayer HealthCare, Cardiorentis, CorThera, Cytokinetics, CytoPherx, DebioPharm, Errekappa Terapeutici, GlaxoSmithKline, Ikaria, Intersection Medical, INC, Johnson and Johnson, Medtronic, Merck, Novartis Pharma, Ono Pharma USA, Otsuka Pharmaceuticals, Palatin Technologies, Pericor Therapeutics, Protein Design Laboratories, Sanofi-Aventis, Sigma Tau, Solvay Pharmaceuticals, Sticares InterACT, Takeda Pharmaceuticals, and Trevena Therapeutics for service as a consultant.

Ovidiu Chioncel has received research support from Novartis, Servier, Abbott Laboratories, Philips, and Vifor, and has also received compensation from Novartis, Servier, and Philips for service as a consultant.

Robert J. Mentz receives research support from Amgen, AstraZeneca, BMS, GSK, Gilead, Novartis, Otsuka, and ResMed; honoraria from Thoratec.

Javed Butler has received research support from the National Institutes of Health (NIH), Health Resources and Services Administration, European Commission, Amgen, Medtronic, Novartis, and Otsuka and has received compensation from Amgen, Bayer, BG Medicine, Cardiocell, Celladon, Gambro, GE Healthcare, Medtronic, Novartis, Ono Pharma, Otsuka, Takeda, Trevena, and Zensun.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Division of Cardiology, Duke University Medical Center, Durham, NC, USA

    Andrew P. Ambrosy

  2. Center for Cardiovascular Innovation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Mihai Gheorghiade

  3. University of Medicine Carol Davila, Institute of Emergency for Cardiovascular Diseases Prof. C.C. Iliescu, Bucuresti, Romania

    Ovidiu Chioncel

  4. Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA

    Robert J. Mentz

  5. Division of Cardiology, Emory University, Atlanta, GA, USA

    Javed Butler

  6. Emory Clinical Cardiovascular Research Institute, 1462 Clifton Road Northeast, Suite AT 504, Atlanta, GA, 30322, USA

    Javed Butler

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  1. Andrew P. Ambrosy
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  2. Mihai Gheorghiade
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  3. Ovidiu Chioncel
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  4. Robert J. Mentz
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  5. Javed Butler
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Correspondence to Javed Butler.

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Ambrosy, A.P., Gheorghiade, M., Chioncel, O. et al. Global Perspectives in Hospitalized Heart Failure: Regional and Ethnic Variation in Patient Characteristics, Management, and Outcomes. Curr Heart Fail Rep 11, 416–427 (2014). https://doi.org/10.1007/s11897-014-0221-9

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