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      9‐Year Trend in the Management of Acute Heart Failure in Japan: A Report From the National Consortium of Acute Heart Failure Registries

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          Abstract

          Background

          Acute heart failure ( AHF) is a heterogeneous condition, and its characteristics and management patterns differ by region. Furthermore, limited evidence is available on AHF outside of Western countries. A project by the National Consortium of Acute Heart Failure Registries was designed to evaluate the trends over time in patient backgrounds, in‐hospital management patterns, and long‐term outcomes of patients with AHF over 9 years in Japan.

          Methods and Results

          Between 2007 and 2015, registry data for patients with AHF were collected from 3 large‐scale quality AHF registries ( ATTEND/ WETHF/ REALITYAHF). Predefined end points were trends over time in age, sex, and clinical outcomes, including short‐ and long‐term mortality and readmission for heart failure. The final data set consisted of 9075 patients with AHF. No significant differences in patient backgrounds and laboratory findings (eg, anemia or renal function) were observed, with the exception of patient age; mean age became substantially higher over 9 years (71.6–77.0 years; P for trend, <0.001). On the contrary, length of hospital stay became shorter (mean, 26–16 days). These changes were not associated with in‐hospital mortality (4.7–7.5%) or 30‐day heart failure readmission rate (4.8–5.4%), as well as 1‐year mortality and heart failure readmission rate (20.1–23.3% and 23.6–26.2%, respectively).

          Conclusions

          Length of hospital stay in patients with AHF shortened over the 9‐year period despite the increasing age of the patients. However, short‐ and long‐term outcomes do not seem to be affected; continuous efforts to monitor clinical outcomes in patients with AHF are needed.

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          Most cited references11

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          The global health and economic burden of hospitalizations for heart failure: lessons learned from hospitalized heart failure registries.

          Heart failure is a global pandemic affecting an estimated 26 million people worldwide and resulting in more than 1 million hospitalizations annually in both the United States and Europe. Although the outcomes for ambulatory HF patients with a reduced ejection fraction (EF) have improved with the discovery of multiple evidence-based drug and device therapies, hospitalized heart failure (HHF) patients continue to experience unacceptably high post-discharge mortality and readmission rates that have not changed in the last 2 decades. In addition, the proportion of HHF patients classified as having a preserved EF continues to grow and may overtake HF with a reduced EF in the near future. However, the prognosis for HF with a preserved EF is similar and there are currently no available disease-modifying therapies. HHF registries have significantly improved our understanding of this clinical entity and remain an important source of data shaping both public policy and research efforts. The authors review global HHF registries to describe the patient characteristics, management, outcomes and their predictors, quality improvement initiatives, regional differences, and limitations of the available data. Moreover, based on the lessons learned, they also propose a roadmap for the design and conduct of future HHF registries. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
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            Time-to-Furosemide Treatment and Mortality in Patients Hospitalized With Acute Heart Failure

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              Epidemiology of heart failure in Asia.

              Heart failure (HF) is a global epidemic in health care and a leading cause of mortality and morbidity worldwide. In Asian countries, causes of mortality and morbidity have shifted or have been shifting from infectious diseases and/or nutritional deficiencies to lifestyle-related diseases, such as cardiovascular disease, cancers and diabetes, in conjunction with the transition from developing to developed countries during the past decades (so-called "the epidemiologic transition"). Because the effect of this epidemiologic transition varies among countries, the etiology, prevalence, management and outcomes of HF also differ among the countries. Thus, we need to assemble and comprehensively analyze the available evidence to date for daily HF practice in Asia and to systematically conduct future epidemiologic approaches to establishing appropriate prevention programs against the burden of HF in Asia. This review article will briefly update the epidemiology of HF in Asia.
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                Author and article information

                Contributors
                sk@keio.jp
                Journal
                J Am Heart Assoc
                J Am Heart Assoc
                10.1002/(ISSN)2047-9980
                JAH3
                ahaoa
                Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
                John Wiley and Sons Inc. (Hoboken )
                2047-9980
                12 September 2018
                18 September 2018
                : 7
                : 18 ( doiID: 10.1002/jah3.2018.7.issue-18 )
                : e008687
                Affiliations
                [ 1 ] Department of Cardiology Keio University School of Medicine Tokyo Japan
                [ 2 ] Internal Medicine, Cardiology, and Intensive Care Unit Nippon Medical School Musashi‐Kosugi Hospital Kanagawa Japan
                [ 3 ] Department of Internal Medicine Nippon Medical School Tokyo Japan
                [ 4 ] Department of Cardiovascular Medicine Kobe City Medical Center General Hospital Kobe Japan
                [ 5 ] Department of Cardiology Sakakibara Heart Institute Tokyo Japan
                [ 6 ] Department of Cardiovascular Medicine Juntendo University School of Medicine Tokyo Japan
                [ 7 ] Cardiovascular Respiratory Sleep Medicine Juntendo University Graduate School of Medicine Tokyo Japan
                Author notes
                [*] [* ] Correspondence to: Shun Kohsaka, MD, Department of Cardiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku‐ku, Tokyo 160‐8582, Japan. E‐mail: sk@ 123456keio.jp
                Article
                JAH33435
                10.1161/JAHA.118.008687
                6222932
                30371201
                47335559-6d1e-4ce4-bd9b-b0548f64e90f
                © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 19 January 2018
                : 17 July 2018
                Page count
                Figures: 4, Tables: 3, Pages: 10, Words: 6207
                Funding
                Funded by: Japanese Heart Foundation
                Award ID: 342007
                Funded by: Grant‐in‐Aid for Scientific Research
                Award ID: 23591062
                Award ID: 26461088
                Funded by: Health Labour Sciences Research Grant
                Award ID: 14528506
                Funded by: Sakakibara Clinical Research Grant for Promotion of Sciences
                Funded by: Japan Agency for Medical Research and Development
                Award ID: 201439013C
                Funded by: Cardiovascular Research Fund, Tokyo
                Categories
                Original Research
                Original Research
                Epidemiology
                Custom metadata
                2.0
                jah33435
                18 September 2018
                Converter:WILEY_ML3GV2_TO_NLMPMC version:version=5.4.7.1 mode:remove_FC converted:18.09.2018

                Cardiovascular Medicine
                acute heart failure,japan,mortality,readmission,time trend,heart failure,epidemiology,aging,mortality/survival

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