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Mohd Ghazi A, Abdul Ghapar AK, Abdul Malek AM, Ross NT, Zainal Abidin I, Mat Lawi F, Foo YW, Mahadevan G, Muthusamy TS, Queck GT, Cham YL, Abdul Wahab MJ, Mohamed MS, Zainal Abidin SK, Wan Ahmad WA. Key comorbidities and laboratory findings: insights from first prospective, observational and Multi-Center Malaysia Heart Failure (MYHF) registry. Eur Heart J 2023. [DOI: 10.1093/eurheartj/ehac779.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Private company. Main funding source(s): Novartis Corporation Sdn Bhd
Background
In real world settings, factors that may affect prognosis of HF patients include comorbidities, lack of guideline-directed medical therapies (GDMT) and laboratory findings in particular elevated cardiac biomarkers.
Purpose
This report aimed to provide insights into these important clinical characteristics in hospitalized HF patients.
Methods
MYHF registry is a prospective, observational study of symptomatic HF patients (NYHA II-IV) hospitalized in 18 tertiary care centers in Malaysia over a period of 3 years starting in 2019. The key comorbidities, GDMT and natriuretic peptides (NP) utilization in hospitalized HF patients enrolled in MYHF Registry will be analyzed.
Results
A total of 2,717 patients, mean age 60.17 years (SD 13.62) and predominantly males (66.8%) were recruited. Mean left ventricular ejection fraction (LVEF) was 36.5% (SD 15.3); with 64.6% HFrEF (LVEF ≤40%), 21.6% HFpEF (LVEF ≥50%) and 11.3% HFmrEF (LVEF 41-49%). Hypertension was the most common comorbidity (71.5%), followed by diabetes (59.8%), ischemic heart disease (55.9%), dyslipidemia (46.6%) and chronic kidney disease (30.9%). At admission, mean SBP was 137.6 mmHg (SD 29), with 5.9% and 42.6% of patients with SBP < 100 mmHg and ≥ 140 mmHg, respectively. Mean HbA1c value was 7.56% (SD 2.0). Mean total cholesterol and LDL-C were 4.30 mmol/L (SD 1.66) and 2.62 mmol/L (SD 1.34), respectively. At admission, mean serum creatinine was 145.76 umol/L (SD 119.64) and 1 out of 2 patients (55.1%) had eGFR <60 mL/min/1.73 m2. Utilization of natriuretic peptide as biomarker was low (16.5%), with NTproBNP being more commonly used (81.5%). Half (49.2%) of patients with NT-proBNP measured had values >=5000 pg/ml. Hospitalization has been known to provide good opportunity for GDMT optimization. Although about two third (59.2%) of patients in this registry had previous history of heart failure hospitalization, only 33.7% of patients were on dual GDMT (ACEi/ARB/ARNI +BB) and 1 out of 10 (13.5%) were on triple GDMT (ACEi/ARB/ARNI+BB+MRA) during admission.
Conclusions
Hospitalized HF patients in MYHF registry are generally young, with high prevalence of co-morbidities, worse laboratory findings and had under-utilization of GDMT. The knowledge gained will be crucial for guiding management of HF patients to improve the prognosis.
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Affiliation(s)
- A Mohd Ghazi
- Institut Jantung Negara , Kuala Lumpur , Malaysia
| | | | - A M Abdul Malek
- Hospital Serdang, Department of Cardiology , Serdang , Malaysia
| | - N T Ross
- Hospital Kuala Lumpur, Medical Department , Kuala Lumpur , Malaysia
| | - I Zainal Abidin
- University Malaya Medical Centre (UMMC), Department of Cardiology , Kuala Lumpur , Malaysia
| | - F Mat Lawi
- Hospital Serdang, Department of Cardiology , Serdang , Malaysia
| | - Y W Foo
- Novartis Corporation (Sdn Bhd) , Kuala Lumpur , Malaysia
| | - G Mahadevan
- Hospital Sultanah Aminah, Department of Cardiology , Johor Bahru , Malaysia
| | - T S Muthusamy
- Cardiac Vascular Sentral Kuala Lumpur (CVSKL) , Kuala Lumpur , Malaysia
| | - G T Queck
- Hospital Melaka, Department of Medicine , Melaka , Malaysia
| | - Y L Cham
- Sarawak Heart Center, Department of Cardiology , Sarawak , Malaysia
| | - M J Abdul Wahab
- Penang Hospital, Department of Cardiology , Penang , Malaysia
| | - M S Mohamed
- Hospital Raja Perempuan Zainab II, Cardiology Unit , Kelantan , Malaysia
| | - S K Zainal Abidin
- Hospital Tengku Ampuan Afzan, Department of Cardiology , Kuantan , Malaysia
| | - W A Wan Ahmad
- University Malaya Medical Centre (UMMC), Department of Cardiology , Kuala Lumpur , Malaysia
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