Related Experiment Video

Updated: Nov 9, 2025

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
05:16

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure

Published on: June 10, 2025

357

Global Differences in Burden and Treatment of Ischemic Heart Disease in Acute Heart Failure: REPORT-HF

Jasper Tromp1, Wouter Ouwerkerk2, John G F Cleland3

  • 1National Heart Centre Singapore, Singapore; Duke-NUS Medical School Singapore, Singapore; University Medical Centre Groningen, Groningen, the Netherlands.

JACC. Heart Failure
|April 11, 2021
PubMed

Insights

Ischemic heart disease (IHD) is more prevalent in low-income countries among patients with acute heart failure (AHF). These patients face worse outcomes and receive less treatment, particularly those with heart failure with reduced ejection fraction (HFrEF).

Area of Science:

  • Cardiology
  • Global Health
  • Epidemiology

Background:

  • Data on ischemic heart disease (IHD) in acute heart failure (AHF) patients are limited globally, with most originating from Western Europe and North America.
  • Understanding global disparities in IHD treatment and prognosis within AHF populations is crucial for equitable healthcare.

Purpose of the Study:

  • To investigate global variations in the prevalence, outcome associations, and treatment of IHD in patients with AHF.
  • To analyze these differences within the large, international REPORT-HF registry.

Main Methods:

  • Prospective enrollment of 18,539 AHF patients from 44 countries in the REPORT-HF registry.
  • Classification of IHD based on a history of coronary artery disease, ischemic event causing AHF admission, or prior coronary revascularization.
  • Exploration of clinical characteristics, treatment patterns, and outcomes for patients with and without IHD.

Main Results:

  • IHD was present in 53% of AHF patients, being more common in lower-income countries (61% vs. 48%).
  • Patients with IHD were older, more likely to have heart failure with reduced ejection fraction (HFrEF), and had more comorbidities.
  • IHD was independently associated with worse cardiovascular death (HR 1.21), with a stronger association in HFrEF.

Conclusions:

  • Ischemic heart disease (IHD) is more prevalent in low-income countries among acute heart failure (AHF) patients, correlating with worse 1-year mortality, especially in HFrEF.
  • Patients in regions with a higher burden of IHD were less likely to receive guideline-recommended treatments like coronary revascularization.
  • Significant global disparities exist in the management and outcomes of AHF patients with IHD.
Abstract

Keywords:
evidence-based pharmacotherapyheart failureischemic heart diseaseoutcomes

More Related Videos

Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control05:41

Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control

Published on: December 16, 2022

4.0K
Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs14:35

Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs

Published on: April 17, 2021

8.8K

Related Concept Videos

Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
70
Heart Failure IV: Classification and Diagnostic Evaluation01:30

Heart Failure IV: Classification and Diagnostic Evaluation

Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
114
Heart Failure I: Introduction01:27

Heart Failure I: Introduction

Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
193
Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
2.1K
Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
80
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
75