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Eur Heart J. 2016 Nov 1;37(41):3141-3153. Epub 2016 Aug 7.

Regional and ethnic differences among patients with heart failure in Asia: the Asian sudden cardiac death in heart failure registry.

Author information

1
National Heart Centre Singapore, Singapore, Singapore carolyn.lam@duke-nus.edu.sg.
2
Duke-National University of Singapore, Singapore, Singapore.
3
Cardiovascular Research Institute, National University Heart Centre, Singapore, Singapore.
4
National Heart Centre Singapore, Singapore, Singapore.
5
School of Population Health, University of Western Australia, WA, Australia.
6
VA Medical Center, University of Minnesota, Minneapolis, USA.
7
Fuwai Hospital, Beijing, The People's Republic of China.
8
National Cardiovascular Centre, Tokyo, Japan.
9
CARE Hospital, Hyderabab, India.
10
Korea University Hospital, Seoul, Korea.
11
Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, The People's Republic of China.
12
Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
13
Institut Jantung Negara, Kuala Lumpur, Malaysia.
14
Manila Doctors Hospital, Manila, Philippines.
15
National Cardiovascular Center Universitas Indonesia, Jakarta, Indonesia.
16
Mackay Memorial Hospital, Taipei, Taiwan.
17
Changi General Hospital, Singapore, Singapore.

Abstract

AIMS:

To characterize regional and ethnic differences in heart failure (HF) across Asia.

METHODS AND RESULTS:

We prospectively studied 5276 patients with stable HF and reduced ejection fraction (≤40%) from 11 Asian regions (China, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, Philippines, Singapore, Taiwan, and Thailand). Mean age was 59.6 ± 13.1 years, 78.2% were men, and mean body mass index was 24.9 ± 5.1 kg/m2. Majority (64%) of patients had two or more comorbid conditions such as hypertension (51.9%), coronary artery disease (CAD, 50.2%), or diabetes (40.4%). The prevalence of CAD was highest in Southeast Asians (58.8 vs. 38.2% in Northeast Asians). Compared with Chinese ethnicity, Malays (adjusted odds ratio [OR] 1.97, 95% CI 1.63-2.38) and Indians (OR 1.44, 95% CI 1.24-1.68) had higher odds of CAD, whereas Koreans (OR 0.38, 95% CI 0.29-0.50) and Japanese (OR 0.44, 95% CI 0.36-0.55) had lower odds. The prevalence of hypertension and diabetes was highest in Southeast Asians (64.2 and 49.3%, respectively) and high-income regions (59.7 and 46.2%, respectively). There was significant interaction between ethnicity and region, where the adjusted odds were 3.95 (95% CI 2.51-6.21) for hypertension and 4.91 (95% CI 3.07-7.87) for diabetes among Indians from high- vs. low-income regions; and 2.60 (95% CI 1.66-4.06) for hypertension and 2.62 (95% CI 1.73-3.97) for diabetes among Malays from high- vs. low-income regions.

CONCLUSIONS:

These first prospective multi-national data from Asia highlight the significant heterogeneity among Asian patients with stable HF, and the important influence of both ethnicity and regional income level on patient characteristics.

CLINICALTRIALSGOV IDENTIFIER:

NCT01633398.

KEYWORDS:

Asia; Epidemiology; Ethnicity; Heart failure; Risk factors

PMID:
27502121
DOI:
10.1093/eurheartj/ehw331
[Indexed for MEDLINE]

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