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In 2014, the Optimize Heart Failure Care Programme was introduced to 12 cardiology training institutions in the Philippines through partnership with the Philippine Heart Association Council on Heart Failure. The Heart Failure Registry, an ongoing, prospective, multicentre, observational study of patients, is part of this Programme. This study aimed to describe the characteristics, trends in treatment patterns and in-hospital outcomes of heart failure patients with reduced ejection fraction (HFrEF) (ejection fraction of 50% or lower) enrolled in the Heart Failure Registry from 2014 to 2018. The registry included all hospitalised adult patients who fulfill the Framingham criteria for the diagnosis of HF. During the study period, the Heart Failure Registry enrolled 636 patients with HFrEF, with a mean age of 56.7 ± 15.2 years; 60.1% were males. The Heart Failure Registry showed that the use of ACEI/ARBs, beta-blockers, MRAs and ivabradine in patients with HFrEF is suboptimal. Just over half of patients were given angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) (54.9%), while 47.5% received beta-blockers and 26.5% received mineralocorticoid receptor antagonists (MRA). Only 6.6% of patients (6.6%) received ivabradine. The overall in-hospital mortality rate was 3.9%. The utilisation rates of guideline-directed pharmacotherapy, particularly for ACEI/ARBs and beta-blockers, followed the scale of educational activities of the Optimize Heart Failure Care programme. Hence, continuation of the programme, including its educational components, and continuous monitoring of performance measures is recommended.

In the Asia-Pacific region, heart failure (HF) is associated with significant health and socioeconomic burden. Given the differences in the epidemiology of HF, as well as the availability of healthcare resources between Asian and Western countries, an Asian Pacific Society of Cardiology (APSC) working group developed consensus recommendations on the management of chronic HF in the Asia-Pacific region. The APSC expert panel reviewed and appraised the available evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Consensus recommendations were developed and put to an online vote. Consensus was reached when 80% of votes for a given recommendation were either ‘agree’ or ‘neutral’. The resulting statements provide guidance on the diagnosis, assessment and treatment of patients with HF with reduced, mildly reduced or preserved ejection fraction in the Asia-Pacific region.

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