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Prognosis of patients with heart failure and reduced ejection fraction in China

Yu Xu1, Yanan Shi, Zhongyu Zhu

  • 1Department of Cardiology, Henan Province People's Hospital, The People's Hospital of Zhengzhou University, Zhengzhou, Henan 450003, P.R. China.

Experimental and Therapeutic Medicine
|November 21, 2013
PubMed

Insights

Patients with heart failure with reduced ejection fraction (HFrEF) in China face poor prognoses, especially those with left ventricular ejection fraction (LVEF) ≤35%. Optimal medication use and guideline adherence are crucial for improving survival rates in these patients.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Public Health

Background:

  • Chronic heart failure (HF) with reduced ejection fraction (HFrEF) poses a significant health burden globally.
  • Understanding survival rates and medication adherence in specific populations, like Chinese patients, is critical for effective management.
  • Reduced ejection fraction (HFrEF) is a key indicator of cardiac dysfunction and impacts patient prognosis.

Purpose of the Study:

  • To investigate the 5-year survival and medication status of patients with HFrEF in China.
  • To identify predictors of mortality in this patient cohort.
  • To compare outcomes between patients with different levels of reduced ejection fraction (LVEF ≤35% vs. LVEF 36-45%).

Main Methods:

  • Single-center, retrospective study enrolling 685 patients with HFrEF (LVEF ≤45%).
  • Patients were divided into two groups: LVEF ≤35% (n=371) and LVEF 36-45% (n=314).
  • Follow-up for a median of 31 months; Cox regression and Kaplan-Meier analyses were used to assess mortality predictors and survival times.

Main Results:

  • Overall mortality was 28% (19% due to pump failure, 6% sudden death).
  • Predictors of all-cause mortality included advanced age, higher BMI, advanced New York Heart Association functional class, and lack of oral beta-blockers at discharge.
  • Only 24% of patients on ACEI/ARB and 23% on beta-blockers reached maximum tolerated doses.

Conclusions:

  • Patients with HFrEF in China exhibit poor prognoses, particularly those with LVEF ≤35%.
  • Effective management requires optimizing medication titration (ACEI/ARB, beta-blockers) and adherence to HF guidelines.
  • Cardiologists must prioritize guideline-based diagnosis and treatment to improve outcomes for Chinese HF patients.

Keywords:
heart failureleft ventricular ejection fractionmedication status quoprognosis

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