Global Variations in Heart Failure Etiology, Management, and Outcomes.

Area of Science:

• Cardiology
• Global Health
• Epidemiology

Background:

• Heart failure (HF) epidemiological data are predominantly from high-income nations, limiting global understanding.
• Significant disparities in HF etiology, treatment, and outcomes exist across different economic development levels.

Purpose of the Study:

• To investigate variations in heart failure (HF) causes, treatments, and patient outcomes across countries with differing economic statuses.
• To provide data for improving global HF prevention and management strategies.

Main Methods:

• A multinational registry included 23,341 participants from 40 countries across high, upper-middle, lower-middle, and low-income classifications.
• Follow-up was conducted for a median of 2.0 years, assessing HF etiology, medication use, hospitalization, and mortality.

Main Results:

• Ischemic heart disease and hypertension were the most common HF causes. Optimal HF medication use was lowest in lower-income countries.
• Standardized mortality rates and 30-day case-fatality rates after hospital admission were substantially higher in lower-income countries.
• Hospitalization rates relative to death rates varied, being less frequent in low-income countries compared to high-income nations.

Conclusions:

• Significant differences in HF etiology, management, and outcomes were observed across economic levels.
• Findings underscore the need for tailored global strategies to address HF disparities and improve patient care worldwide.