Temporal trends in clinical characteristics, management and prognosis of patients with symptomatic heart failure in japan “ Report from the CHART studies

Ryoichi Ushigome, Yasuhiko Sakata, Kotaro Nochioka, Satoshi Miyata, Masanobu Miura, Soichiro Tadaki, Takeshi Yamauchi, Kenjiro Sato, Takeo Onose, Kanako Tsuji, Ruri Abe, Takuya Oikawa, Shintaro Kasahara, Jun Takahashi, Hiroaki Shimokawa

Research output: Contribution to journalArticlepeer-review

55 Citations (Scopus)

Abstract

Background: Temporal trends in clinical characteristics, management and prognosis of patients with symptomatic heart failure (HF) remain to be elucidated in Japan. Methods and Results: From the Chronic Heart Failure Analysis and Registry in the Tohoku District-1 (CHART-1; 2000–2005, n=1,278) and CHART-2 (2006-present, n=10,219) Studies, we enrolled 1,006 and 3,676 consecutive symptomatic stage C/D HF patients, respectively. As compared with the patients in the CHART-1 Study, those in the CHART-2 Study had similar age and sex prevalence, and were characterized by lower brain natriuretic peptide, higher prevalence of preserved left ventricular ejection fraction (LVEF) and higher prevalence of hypertension, diabetes mellitus and ischemic heart disease (IHD), particularly IHD with LVEF ≥50%. From CHART-1 to CHART-2, use of renin-angiotensin system inhibitors, β-blockers and aldosterone antagonists was significantly increased, while that of loop diuretics and digitalis was decreased. Three-year incidences of all-cause death (24 vs. 15%; adjusted hazard ratio [adjHR], 0.73; P<0.001), cardiovascular death (17 vs. 7%; adjHR, 0.38; P<0.001) and hospitalization for HF (30 vs. 17%; adjHR, 0.51; P<0.001) were all significantly decreased from CHART-1 to CHART-2. In the CHART-2 Study, use of β-blockers was associated with improved prognosis in patients with LVEF <50%, while that of statins was associated with improved prognosis in those with LVEF ≥50%. Conclusions: Along with implementation of evidence-based medications, the prognosis of HF patients has been improved in Japan. (Trial registration: clinicaltrials.gov identifier: NCT00418041).

Original languageEnglish
Pages (from-to)2396-2407
Number of pages12
JournalCirculation Journal
Volume79
Issue number11
DOIs
Publication statusPublished - 2015 Oct 23

Keywords

  • Beta-blocker
  • Prognosis
  • Statin
  • Symptomatic heart failure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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