Heart failure as a general pandemic in Asia

Shimokawa, Hiroaki; Miura, Masanobu; Nochioka, Kotaro; Sakata, Yasuhiko

doi:10.1002/ejhf.319

Cited by 345 publications

(266 citation statements)

References 58 publications

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“…In part due to the ageing of the population and more effective treatment of chronic heart failure (HF), its prevalence is expected to increase by 25% over the next 20 years 3 and the problem has expanded worldwide 4, 5. Patients hospitalized for HF have a 40–50% rate of HF exacerbation, of which 10–15% is in‐hospital worsening heart failure (WHF)6, 7, 8, 9, 10 and 30–40% is rehospitalization, within the first 6 months after discharge as well as a 10–15% mortality rate 11.…”

Section: Introductionmentioning

confidence: 99%

Serelaxin in addition to standard therapy in acute heart failure: rationale and design of the RELAX‐AHF‐2 study

Teerlink

Voors

Ponikowski

et al. 2017

European J of Heart Fail

109

103

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Patients admitted for acute heart failure (AHF) experience high rates of in‐hospital and post‐discharge morbidity and mortality despite current therapies. Serelaxin is recombinant human relaxin‐2, a hormone with vasodilatory and end‐organ protective effects believed to play a central role in the cardiovascular and renal adaptations of human pregnancy. In the phase 3 RELAX‐AHF trial, serelaxin met its primary endpoint of improving dyspnoea through day 5 in patients admitted for AHF. Compared to placebo, serelaxin also reduced worsening heart failure (WHF) by 47% through day 5 and both all‐cause and cardiovascular mortality by 37% through day 180. RELAX‐AHF‐2 ( ClinicalTrials.gov NCT01870778) is designed to confirm serelaxin's effect on these clinical outcomes. RELAX‐AHF‐2 is a multicentre, randomized, double‐blind, placebo‐controlled, event‐driven, phase 3 trial enrolling ∼6800 patients hospitalized for AHF with dyspnoea, congestion on chest radiograph, increased natriuretic peptide levels, mild‐to‐moderate renal insufficiency, and systolic blood pressure ≥125 mmHg. Patients are randomized within 16 h of presentation to 48 h intravenous infusions of serelaxin (30 µg/kg/day) or placebo, both in addition to standard of care treatments. The primary objectives are to demonstrate that serelaxin is superior to placebo in reducing: (i) 180 day cardiovascular death, and (ii) occurrence of WHF through day 5. Key secondary endpoints include 180 day all‐cause mortality, composite of 180 day combined cardiovascular mortality or heart failure/renal failure rehospitalization, and in‐hospital length of stay during index AHF. The results from RELAX‐AHF‐2 will provide data on the potential beneficial effect of serelaxin on cardiovascular mortality and WHF in selected patients with AHF.

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Section: Introductionmentioning

confidence: 99%

Serelaxin in addition to standard therapy in acute heart failure: rationale and design of the RELAX‐AHF‐2 study

Teerlink

Voors

Ponikowski

et al. 2017

European J of Heart Fail

109

103

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“…Other than tolvaptan, carperitide is also available only in Japan, and the use of nicorandil and landiolol for ADHF management is at present limited in Japan 28. In addition, the estimated prevalence of HF in Japan is less than 1% at present, which is relatively low compared with Western countries, and the ischaemic aetiology of ADHF is less common in Japan than in Western countries 29. Although there are several differences between Japan and other countries in both characteristics and management of ADHF, a comprehensive strategy for ADHF management ultimately should not differ significantly between Japan and other countries.…”

Section: Discussionmentioning

confidence: 99%

“…Although there are several differences between Japan and other countries in both characteristics and management of ADHF, a comprehensive strategy for ADHF management ultimately should not differ significantly between Japan and other countries. Moreover, compared with other countries, Japan has experienced a marked increase in the ageing population, 30 and the incidence of new onset heart failure has also rapidly increased in recent years 2, 29. As the result of the increase in the ageing population, we are currently facing a worldwide heart failure pandemic, and the risk is particularly great in developed countries.…”

Section: Discussionmentioning

confidence: 99%

Kyoto Congestive Heart Failure (KCHF) study: rationale and design

et al. 2017

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AimsOver the last decade, major developments in medicine have led to significant changes in the clinical management of heart failure patients. This study was designed to evaluate the recent trends in clinical characteristics, management, and short‐term and long‐term prognosis of patients with acute decompensated heart failure (ADHF) in Japan.Methods and resultsThe Kyoto Congestive Heart Failure study is a prospective, observational, multicentre cohort study, enrolling consecutive ADHF patients from 19 participating hospitals in Japan from November 2014 to March 2016. A total of 4000 patients will be enrolled into the study and patients' anthropometric, socio‐economic, and clinical data from hospital admission to discharge will be collected. In addition, in a pre‐determined subgroup of patients (n=1500), a longitudinal follow‐up for 2 years is scheduled.ConclusionsThe Kyoto Congestive Heart Failure study will provide valuable information regarding patients with ADHF in the real‐world clinical practice of Japan and will be indispensable for future clinical and policy decision‐making with respect to heart failure.

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“…The clinical characteristics, treatment, and outcome of HF patients have been well described in the western population with registries and clinical trials contributing much to our present understanding of the disease. But, still differences exist between the western and the Indian population, and there are only limited data on HF from this part of the world 1. Heart failure in the Indian population occurs at a comparatively younger age group with low level of education, poverty, and poor access to healthcare facilities associated with poor outcomes.…”

Section: Introductionmentioning

confidence: 99%

Demographical and clinicopathological characteristics in heart failure and outcome predictors: a prospective, observational study

et al. 2016

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AimsThe aims of the study were to study the demographical and clinicopathological characteristics of patients presenting with heart failure and evaluate the 1 year outcomes and to identify risk predictors if any.Methods and resultsA prospective observational study was conducted in consecutive patients of systolic heart failure. The study was divided into two parts—an initial 6 month enrolment phase followed up for 1 year for major adverse cardiovascular events. All patients were treated according to the Institutional Heart Failure Protocol. Demographical and clinicopathophysiological characteristics were studied, and results were analysed. A total of 143 patients were enrolled. The mean age of subjects was 56.4 years with male subjects constituting almost two‐thirds of the study population. The commonest aetiology of heart failure was ischemic with valvular heart disease being the commonest cause of non‐ischemic heart failure. Bendopnea, a recently described symptom of heart failure, was found in a significant number of subjects. By univariate analysis, male sex (P = 0.042) and cardiomegaly (P = 0.035) were predictors of rehospitalization, whereas the univariate predictors of mortality were ischemic aetiology (P = 0.000), age > 50 years (P = 0.007), hypertension (P = 0.012), worsening NYHA class (P = 0.003), diabetes mellitus (P = 0.009), and hypokalaemia (P = 0.006). Multivariate analysis performed showed age > 50 years [P = 0.007; OR (CI) = 13.547 (2.034–90.238)], NYHA class [P = 0.002; OR (CI) = 32.300 (3.733–276.532)], and hypokalaemia [P = 0.031; OR (CI) = 7.524 (1.208–46.862)] as significant predictors of mortality during long‐term follow‐up.ConclusionsThe study will definitely help us to throw more light in identifying risk predictors of heart failure and help in improving clinical outcomes.

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Heart failure as a general pandemic in Asia

Cited by 345 publications

References 58 publications

Serelaxin in addition to standard therapy in acute heart failure: rationale and design of the RELAX‐AHF‐2 study

Serelaxin in addition to standard therapy in acute heart failure: rationale and design of the RELAX‐AHF‐2 study

Kyoto Congestive Heart Failure (KCHF) study: rationale and design

Demographical and clinicopathological characteristics in heart failure and outcome predictors: a prospective, observational study

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