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Poor prognosis in chronic heart failure patients with reduced ejection fraction in China

Zhongwei Cheng1, Kongbo Zhu, Taibo Chen

  • 1Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.

Congestive Heart Failure (Greenwich, Conn.)
|May 17, 2012
PubMed

Insights

Heart failure patients in China with reduced ejection fraction (LVEF ≤ 45%) face poor prognosis. Those with severely reduced LVEF (≤ 35%) experienced significantly higher mortality and readmission rates.

Area of Science:

  • Cardiology
  • Clinical Research
  • Public Health

Background:

  • High mortality rates in heart failure (HF) patients with reduced ejection fraction present a significant challenge for Chinese cardiologists.
  • Understanding the prognosis of chronic HF patients in China is crucial for improving patient outcomes.

Purpose of the Study:

  • To evaluate the prognosis of heart failure patients with left ventricular ejection fraction (LVEF) ≤ 45% in China.
  • To identify predictors of mortality and cardiovascular readmission in this patient population.

Main Methods:

  • A single-center, retrospective study enrolled 187 consecutive HF patients with LVEF ≤ 45% between 2007 and 2009.
  • Patients were categorized into two groups: LVEF ≤ 35% (n=83) and LVEF 36% to 45% (n=104).
  • Primary outcome was all-cause mortality; secondary outcome was all-cause mortality or first cardiovascular readmission, with a median follow-up of 18 months.

Main Results:

  • All-cause mortality was significantly higher in the LVEF ≤ 35% group (27%) compared to the LVEF 36% to 45% group (14%) (P=.025).
  • The combined endpoint of all-cause mortality or first cardiovascular readmission was also significantly higher in the LVEF ≤ 35% group (53%) versus the LVEF 36% to 45% group (32%) (P=.003).
  • Predictors of all-cause mortality included advanced age, higher NYHA functional class, chronic kidney disease, and discharge on oral beta-blockers and statins.

Conclusions:

  • The prognosis for chronic heart failure patients with LVEF ≤ 45% in China is poor, particularly for those with LVEF ≤ 35%.
  • Further efforts are needed from cardiologists to improve the management and outcomes of HF patients in China.
  • Identifying predictors of mortality can aid in risk stratification and targeted interventions.

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