Acute heart failure – The ‘real’ Malaysian experience: An observational study from a single non-cardiac centre

Shariff, Raja Ezman Raja; Kasim, Sazzli; Borhan, Marisa Khatijah; Yusoff, M.R.

doi:10.1177/2010105820978664

Cited by 6 publications

(32 citation statements)

References 23 publications

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“…Of the hospitalized HF patients in this study, 62.9% had reduced ejection fraction. A relatively lower proportion of HFrEF patients was reported in the SGH‐HF (51%), UiTM Sungai Buloh (40.8%) and ADHERE‐AP (53%) populations, indicating that half of the hospitalized HF patients had HFmrEF and HFpEF 23–25 . The proportion of patients with preserved ejection fraction in our analysis was much lower than that observed in the GWTG‐HF registry (12.7% vs. 43%, respectively) 28 …”

Section: Discussioncontrasting

confidence: 62%

“…A relatively lower proportion of HFrEF patients was reported in the SGH-HF (51%), UiTM Sungai Buloh (40.8%) and ADHERE-AP (53%) populations, indicating that half of the hospitalized HF patients had HFmrEF and HFpEF. [23][24][25] The proportion of patients with preserved ejection fraction in our analysis was much lower than that observed in the GWTG-HF registry (12.7% vs. 43%, respectively). 28 The higher proportion of HF patients with ischaemic aetiology reported in this study (66%) compared with SGH-HF (41.1%) also explains the observation of a higher prevalence of patients with HFrEF.…”

Section: Hospitalized Hf Patient Profile In Malaysiacontrasting

confidence: 66%

“…The mean age (72.2 years) of patients in the GWTG‐HF registry from the USA was higher by almost a decade than that observed in our study 28 . Comparable age was observed in all three local single‐centre studies, including IJN ADHF registry, SGH‐HF and UiTM Sungai Buloh (mean age of 62, 59 and 63, respectively) 24,25 . These findings suggest that HF patients in Malaysia are relatively younger, which is not surprising.…”

Section: Discussionsupporting

confidence: 46%

“…27,28 Both IJN ADHF and SGH-HF showed similar rates (7.2% and 7.5%, respectively), followed by ADHERE-AP (4.8%) and the UiTM Sungai Buloh study (1.7%). [23][24][25] When 1-year outcome in terms of hospitalization rate was compared between the studies, 76.1% of patients in the UiTM Sungai Buloh study were readmitted within 1 year; meanwhile, one of four (24.7%) was readmitted in the IJN study. 25 Similarly, an extraordinarily high 1-year mortality rate was observed in the UiTM Sungai Buloh study (49.7%), compared with 7.2% in the IJN study.…”

Section: Hospitalized Hf Patient Profile In Malaysiamentioning

confidence: 99%

“…[23][24][25] When 1-year outcome in terms of hospitalization rate was compared between the studies, 76.1% of patients in the UiTM Sungai Buloh study were readmitted within 1 year; meanwhile, one of four (24.7%) was readmitted in the IJN study. 25 Similarly, an extraordinarily high 1-year mortality rate was observed in the UiTM Sungai Buloh study (49.7%), compared with 7.2% in the IJN study. 25 It should be noted that UiTM Sungai Buloh reported data on 1-year all-cause mortality, while the current study reported in-hospital mortality within a year.…”

Section: Hospitalized Hf Patient Profile In Malaysiamentioning

confidence: 99%

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Patient profiles on outcomes in patients hospitalized for heart failure: a 10‐year history of the Malaysian population

2022

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Aims Heart failure (HF) affects an estimated 38 million people worldwide and is the leading cause of hospitalization among adults and the elderly. Evidence suggests that there may be regional and ethnic differences in the prevalence, outcomes and management of HF. The aim of this study was to understand the disease burden and treatment patterns of patients hospitalized for HF in multi-ethnic Malaysia. Methods and results A retrospective, non-interventional study was conducted utilizing 10 years of medical records from the National Heart Institute Malaysia (IJN) from 1 January 2009 to 31 December 2018. Of the 4739 patients in the IJN database, 3923 were eligible and were included in this analysis. The study recorded a high male prevalence (72.3%) with a mean age of 62.0 (±13.26) years. The 30-day and 1-year rehospitalization rate was 6.8% and 24.7%, respectively. In-hospital mortality was 7.2% with 27.0% due to cardiovascular causes and 14.2% non-cardiovascular causes. The 30-day and 1-year rehospitalization rates were significantly higher in patients with lower systolic blood pressure (SBP, P < 0.001 and P = 0.002), diastolic blood pressure (DBP, P < 0.001 and P = 0.017), sodium (P < 0.001 and P = 0.029) and estimated glomerular filtration rate (eGFR, P < 0.001 and P = 0.002) and higher urea (P < 0.001 for both), serum creatinine (P < 0.001 and P = 0.003), and uric acid (P < 0.001 for both), respectively. Risk of hospitalization within 1 year varied significantly by ethnicity and was relatively higher in Indian (28.3%), followed by Malay (24.4%) and Chinese (21.9%; P = 0.008). In-hospital mortality within 1-year post-index date was higher in patients with lower weight (P = 0.002), body mass index (P = 0.009), SBP (P < 0.001), DBP (P < 0.001), sodium (P < 0.001), eGFR (P < 0.001) and higher heart rate (P = 0.039), urea (P < 0.001), serum potassium (P = 0.038), serum creatinine (P < 0.001), and uric acid (P < 0.001). In-hospital mortality within 1-year post-index date was also higher in patients with severe or end-stage chronic kidney disease (CKD) compared with mild/moderate CKD (P < 0.001) and in patients with HF with reduced ejection fraction (HFrEF) compared with those with mid-range or preserved ejection fraction (P < 0.001). The most commonly prescribed HF medications at discharge were loop diuretics (89.2%), β-blockers (68.5%), mineralocorticoid receptor antagonists (56.2%), angiotensin-converting enzyme inhibitors (31.5%), and angiotensin receptor blockers (20.8%). Conclusions This study provides a greater understanding of the characteristics, treatment patterns, and outcome of hospitalized HF patients in a leading referral centre in Malaysia and will aid the implementation of meaningful interventions to improve patient outcome for HF patients.

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Section: Discussioncontrasting

confidence: 62%

Section: Hospitalized Hf Patient Profile In Malaysiacontrasting

confidence: 66%

Section: Discussionsupporting

confidence: 46%

Section: Hospitalized Hf Patient Profile In Malaysiamentioning

confidence: 99%

Section: Hospitalized Hf Patient Profile In Malaysiamentioning

confidence: 99%

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Patient profiles on outcomes in patients hospitalized for heart failure: a 10‐year history of the Malaysian population

2022

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Characteristics of patients admitted with heart failure: Insights from the first Malaysian Heart Failure Registry

Wan Ahmad,

Abdul Ghapar,

Zainal Abidin

et al. 2023

ESC Heart Failure

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AimsHeart failure (HF) is a growing health problem, yet there are limited data on patients with HF in Malaysia. The Malaysian Heart Failure (MY‐HF) Registry aims to gain insights into the epidemiology, aetiology, management, and outcome of Malaysian patients with HF and identify areas for improvement within the national HF services.Methods and resultsThe MY‐HF Registry is a 3‐year prospective, observational study comprising 2717 Malaysian patients admitted for acute HF. We report the description of baseline data at admission and outcomes of index hospitalization of these patients. The mean age was 60.2 ± 13.6 years, 66.8% were male, and 34.3% had de novo HF. Collectively, 55.7% of patients presented with New York Heart Association (NYHA) Class III or IV; ischaemic heart disease was the most frequent aetiology (63.2%). Most admissions (87.3%) occurred via the emergency department, with 13.7% of patients requiring intensive care, and of these, 21.8% needed intubation. The proportion of patients receiving guideline‐directed medical therapy increased at discharge (84.2% vs. 93.6%). The median length of stay (LOS) was 5 days, and in‐hospital mortality was 2.9%. Predictors of LOS and/or in‐hospital mortality were age, NYHA class, estimated glomerular filtration rate, and comorbid anaemia. LOS and in‐hospital mortality were similar regardless of ejection fraction.ConclusionsThe MY‐HF Registry showed that the HF population in Malaysia is younger, predominantly male, and ischaemic‐driven and has good prospects with hospitalization for optimization of treatment. These findings suggest a need to reassess current clinical practice and guide resource allocation to improve patient outcomes.

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Examining health-related quality of life in ambulatory adult patients with chronic heart failure: insights from Malaysia using EQ-5D-5L

Tan,

Ong,

Yong

et al. 2024

Qual Life Res

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Acute heart failure – The ‘real’ Malaysian experience: An observational study from a single non-cardiac centre

Cited by 6 publications

References 23 publications

Patient profiles on outcomes in patients hospitalized for heart failure: a 10‐year history of the Malaysian population

Patient profiles on outcomes in patients hospitalized for heart failure: a 10‐year history of the Malaysian population

Characteristics of patients admitted with heart failure: Insights from the first Malaysian Heart Failure Registry

Examining health-related quality of life in ambulatory adult patients with chronic heart failure: insights from Malaysia using EQ-5D-5L

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