Patients with HFpEF and HFrEF have different clinical characteristics but similar prognosis: a retrospective cohort study
Background Globally, heart failure (HF) has been recognized as one of the major cardiovascular disorder with high morbidity, mortality and considerable social impact. In Sub Saharan African countries, HF has turned out as a leading form of cardiovascular diseases, and has considerable socioeconomic...
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| Veröffentlicht in: | BMC cardiovascular disorders Jg. 16; H. 1; S. 232 |
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BioMed Central
21.11.2016
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| Abstract | Background
Globally, heart failure (HF) has been recognized as one of the major cardiovascular disorder with high morbidity, mortality and considerable social impact. In Sub Saharan African countries, HF has turned out as a leading form of cardiovascular diseases, and has considerable socioeconomic impact. However, there are differences in clinical characteristics and survival status among patients with preserved (HFpEF) and reduced (HFrEF) ejection fraction. The aim of this study is to outline the clinical characteristics and medication profile, assess the survival status and prognostic factors of Ethiopian HF patients with HFrEF and HFpEF.
Methods
A retrospective cohort study was carried out and we employed medical records of patient’s, admitted as a result of HF to the University of Gondar Referral Hospital in the period between December 02, 2010 and December 01, 2015 due to HF. Kaplan Meier curve was used to analyze the survival status and log rank test was used to compare the curves. Cox regression was used to analyze independent predictors of mortality in all HF patients.
Results
Of the 850 patients who were admitted due to HF, 311 patients met the inclusion criteria. Majority of the patients had HFpEF (52.73%) and tend to be women (76.22%). They predominantly had etiologies of valvular and hypertensive heart diseases, and took calcium channel blockers and anticoagulants. Conversely, patients with HFrEF had etiologies of ischemic heart disease and dilated cardiomyopathy and were prescribed angiotensine converting inhibitors (ACEI) and beta blockers. Kaplan Meier curves and Log rank test (
p
= 0.807) showed that there was no statistically significant difference in the mortality difference among patients with HFpEF and HFrEF. On the other hand, Cox regression analysis showed advanced age, lower sodium level, higher creatinine level and absence of medications like ACEI, spironolactone and statins independently predicted mortality in all HF patients.
Conclusions
Different clinical characteristics were found in both groups of HF patients. There was no difference in survival outcome between patients with HFrEF and HFpEF. |
|---|---|
| AbstractList | Background Globally, heart failure (HF) has been recognized as one of the major cardiovascular disorder with high morbidity, mortality and considerable social impact. In Sub Saharan African countries, HF has turned out as a leading form of cardiovascular diseases, and has considerable socioeconomic impact. However, there are differences in clinical characteristics and survival status among patients with preserved (HFpEF) and reduced (HFrEF) ejection fraction. The aim of this study is to outline the clinical characteristics and medication profile, assess the survival status and prognostic factors of Ethiopian HF patients with HFrEF and HFpEF. Methods A retrospective cohort study was carried out and we employed medical records of patient's, admitted as a result of HF to the University of Gondar Referral Hospital in the period between December 02, 2010 and December 01, 2015 due to HF. Kaplan Meier curve was used to analyze the survival status and log rank test was used to compare the curves. Cox regression was used to analyze independent predictors of mortality in all HF patients. Results Of the 850 patients who were admitted due to HF, 311 patients met the inclusion criteria. Majority of the patients had HFpEF (52.73%) and tend to be women (76.22%). They predominantly had etiologies of valvular and hypertensive heart diseases, and took calcium channel blockers and anticoagulants. Conversely, patients with HFrEF had etiologies of ischemic heart disease and dilated cardiomyopathy and were prescribed angiotensine converting inhibitors (ACEI) and beta blockers. Kaplan Meier curves and Log rank test (p = 0.807) showed that there was no statistically significant difference in the mortality difference among patients with HFpEF and HFrEF. On the other hand, Cox regression analysis showed advanced age, lower sodium level, higher creatinine level and absence of medications like ACEI, spironolactone and statins independently predicted mortality in all HF patients. Conclusions Different clinical characteristics were found in both groups of HF patients. There was no difference in survival outcome between patients with HFrEF and HFpEF. Keywords: Heart failure, Ejection fraction, Clinical characteristics, Survival, Ethiopia Globally, heart failure (HF) has been recognized as one of the major cardiovascular disorder with high morbidity, mortality and considerable social impact. In Sub Saharan African countries, HF has turned out as a leading form of cardiovascular diseases, and has considerable socioeconomic impact. However, there are differences in clinical characteristics and survival status among patients with preserved (HFpEF) and reduced (HFrEF) ejection fraction. The aim of this study is to outline the clinical characteristics and medication profile, assess the survival status and prognostic factors of Ethiopian HF patients with HFrEF and HFpEF. A retrospective cohort study was carried out and we employed medical records of patient's, admitted as a result of HF to the University of Gondar Referral Hospital in the period between December 02, 2010 and December 01, 2015 due to HF. Kaplan Meier curve was used to analyze the survival status and log rank test was used to compare the curves. Cox regression was used to analyze independent predictors of mortality in all HF patients. Of the 850 patients who were admitted due to HF, 311 patients met the inclusion criteria. Majority of the patients had HFpEF (52.73%) and tend to be women (76.22%). They predominantly had etiologies of valvular and hypertensive heart diseases, and took calcium channel blockers and anticoagulants. Conversely, patients with HFrEF had etiologies of ischemic heart disease and dilated cardiomyopathy and were prescribed angiotensine converting inhibitors (ACEI) and beta blockers. Kaplan Meier curves and Log rank test (p = 0.807) showed that there was no statistically significant difference in the mortality difference among patients with HFpEF and HFrEF. On the other hand, Cox regression analysis showed advanced age, lower sodium level, higher creatinine level and absence of medications like ACEI, spironolactone and statins independently predicted mortality in all HF patients. Different clinical characteristics were found in both groups of HF patients. There was no difference in survival outcome between patients with HFrEF and HFpEF. Globally, heart failure (HF) has been recognized as one of the major cardiovascular disorder with high morbidity, mortality and considerable social impact. In Sub Saharan African countries, HF has turned out as a leading form of cardiovascular diseases, and has considerable socioeconomic impact. However, there are differences in clinical characteristics and survival status among patients with preserved (HFpEF) and reduced (HFrEF) ejection fraction. The aim of this study is to outline the clinical characteristics and medication profile, assess the survival status and prognostic factors of Ethiopian HF patients with HFrEF and HFpEF.BACKGROUNDGlobally, heart failure (HF) has been recognized as one of the major cardiovascular disorder with high morbidity, mortality and considerable social impact. In Sub Saharan African countries, HF has turned out as a leading form of cardiovascular diseases, and has considerable socioeconomic impact. However, there are differences in clinical characteristics and survival status among patients with preserved (HFpEF) and reduced (HFrEF) ejection fraction. The aim of this study is to outline the clinical characteristics and medication profile, assess the survival status and prognostic factors of Ethiopian HF patients with HFrEF and HFpEF.A retrospective cohort study was carried out and we employed medical records of patient's, admitted as a result of HF to the University of Gondar Referral Hospital in the period between December 02, 2010 and December 01, 2015 due to HF. Kaplan Meier curve was used to analyze the survival status and log rank test was used to compare the curves. Cox regression was used to analyze independent predictors of mortality in all HF patients.METHODSA retrospective cohort study was carried out and we employed medical records of patient's, admitted as a result of HF to the University of Gondar Referral Hospital in the period between December 02, 2010 and December 01, 2015 due to HF. Kaplan Meier curve was used to analyze the survival status and log rank test was used to compare the curves. Cox regression was used to analyze independent predictors of mortality in all HF patients.Of the 850 patients who were admitted due to HF, 311 patients met the inclusion criteria. Majority of the patients had HFpEF (52.73%) and tend to be women (76.22%). They predominantly had etiologies of valvular and hypertensive heart diseases, and took calcium channel blockers and anticoagulants. Conversely, patients with HFrEF had etiologies of ischemic heart disease and dilated cardiomyopathy and were prescribed angiotensine converting inhibitors (ACEI) and beta blockers. Kaplan Meier curves and Log rank test (p = 0.807) showed that there was no statistically significant difference in the mortality difference among patients with HFpEF and HFrEF. On the other hand, Cox regression analysis showed advanced age, lower sodium level, higher creatinine level and absence of medications like ACEI, spironolactone and statins independently predicted mortality in all HF patients.RESULTSOf the 850 patients who were admitted due to HF, 311 patients met the inclusion criteria. Majority of the patients had HFpEF (52.73%) and tend to be women (76.22%). They predominantly had etiologies of valvular and hypertensive heart diseases, and took calcium channel blockers and anticoagulants. Conversely, patients with HFrEF had etiologies of ischemic heart disease and dilated cardiomyopathy and were prescribed angiotensine converting inhibitors (ACEI) and beta blockers. Kaplan Meier curves and Log rank test (p = 0.807) showed that there was no statistically significant difference in the mortality difference among patients with HFpEF and HFrEF. On the other hand, Cox regression analysis showed advanced age, lower sodium level, higher creatinine level and absence of medications like ACEI, spironolactone and statins independently predicted mortality in all HF patients.Different clinical characteristics were found in both groups of HF patients. There was no difference in survival outcome between patients with HFrEF and HFpEF.CONCLUSIONSDifferent clinical characteristics were found in both groups of HF patients. There was no difference in survival outcome between patients with HFrEF and HFpEF. Background Globally, heart failure (HF) has been recognized as one of the major cardiovascular disorder with high morbidity, mortality and considerable social impact. In Sub Saharan African countries, HF has turned out as a leading form of cardiovascular diseases, and has considerable socioeconomic impact. However, there are differences in clinical characteristics and survival status among patients with preserved (HFpEF) and reduced (HFrEF) ejection fraction. The aim of this study is to outline the clinical characteristics and medication profile, assess the survival status and prognostic factors of Ethiopian HF patients with HFrEF and HFpEF. Methods A retrospective cohort study was carried out and we employed medical records of patient’s, admitted as a result of HF to the University of Gondar Referral Hospital in the period between December 02, 2010 and December 01, 2015 due to HF. Kaplan Meier curve was used to analyze the survival status and log rank test was used to compare the curves. Cox regression was used to analyze independent predictors of mortality in all HF patients. Results Of the 850 patients who were admitted due to HF, 311 patients met the inclusion criteria. Majority of the patients had HFpEF (52.73%) and tend to be women (76.22%). They predominantly had etiologies of valvular and hypertensive heart diseases, and took calcium channel blockers and anticoagulants. Conversely, patients with HFrEF had etiologies of ischemic heart disease and dilated cardiomyopathy and were prescribed angiotensine converting inhibitors (ACEI) and beta blockers. Kaplan Meier curves and Log rank test ( p = 0.807) showed that there was no statistically significant difference in the mortality difference among patients with HFpEF and HFrEF. On the other hand, Cox regression analysis showed advanced age, lower sodium level, higher creatinine level and absence of medications like ACEI, spironolactone and statins independently predicted mortality in all HF patients. Conclusions Different clinical characteristics were found in both groups of HF patients. There was no difference in survival outcome between patients with HFrEF and HFpEF. Background Globally, heart failure (HF) has been recognized as one of the major cardiovascular disorder with high morbidity, mortality and considerable social impact. In Sub Saharan African countries, HF has turned out as a leading form of cardiovascular diseases, and has considerable socioeconomic impact. However, there are differences in clinical characteristics and survival status among patients with preserved (HFpEF) and reduced (HFrEF) ejection fraction. The aim of this study is to outline the clinical characteristics and medication profile, assess the survival status and prognostic factors of Ethiopian HF patients with HFrEF and HFpEF. Methods A retrospective cohort study was carried out and we employed medical records of patient's, admitted as a result of HF to the University of Gondar Referral Hospital in the period between December 02, 2010 and December 01, 2015 due to HF. Kaplan Meier curve was used to analyze the survival status and log rank test was used to compare the curves. Cox regression was used to analyze independent predictors of mortality in all HF patients. Results Of the 850 patients who were admitted due to HF, 311 patients met the inclusion criteria. Majority of the patients had HFpEF (52.73%) and tend to be women (76.22%). They predominantly had etiologies of valvular and hypertensive heart diseases, and took calcium channel blockers and anticoagulants. Conversely, patients with HFrEF had etiologies of ischemic heart disease and dilated cardiomyopathy and were prescribed angiotensine converting inhibitors (ACEI) and beta blockers. Kaplan Meier curves and Log rank test (p = 0.807) showed that there was no statistically significant difference in the mortality difference among patients with HFpEF and HFrEF. On the other hand, Cox regression analysis showed advanced age, lower sodium level, higher creatinine level and absence of medications like ACEI, spironolactone and statins independently predicted mortality in all HF patients. Conclusions Different clinical characteristics were found in both groups of HF patients. There was no difference in survival outcome between patients with HFrEF and HFpEF. Globally, heart failure (HF) has been recognized as one of the major cardiovascular disorder with high morbidity, mortality and considerable social impact. In Sub Saharan African countries, HF has turned out as a leading form of cardiovascular diseases, and has considerable socioeconomic impact. However, there are differences in clinical characteristics and survival status among patients with preserved (HFpEF) and reduced (HFrEF) ejection fraction. The aim of this study is to outline the clinical characteristics and medication profile, assess the survival status and prognostic factors of Ethiopian HF patients with HFrEF and HFpEF. A retrospective cohort study was carried out and we employed medical records of patient's, admitted as a result of HF to the University of Gondar Referral Hospital in the period between December 02, 2010 and December 01, 2015 due to HF. Kaplan Meier curve was used to analyze the survival status and log rank test was used to compare the curves. Cox regression was used to analyze independent predictors of mortality in all HF patients. Of the 850 patients who were admitted due to HF, 311 patients met the inclusion criteria. Majority of the patients had HFpEF (52.73%) and tend to be women (76.22%). They predominantly had etiologies of valvular and hypertensive heart diseases, and took calcium channel blockers and anticoagulants. Conversely, patients with HFrEF had etiologies of ischemic heart disease and dilated cardiomyopathy and were prescribed angiotensine converting inhibitors (ACEI) and beta blockers. Kaplan Meier curves and Log rank test (p = 0.807) showed that there was no statistically significant difference in the mortality difference among patients with HFpEF and HFrEF. On the other hand, Cox regression analysis showed advanced age, lower sodium level, higher creatinine level and absence of medications like ACEI, spironolactone and statins independently predicted mortality in all HF patients. Different clinical characteristics were found in both groups of HF patients. There was no difference in survival outcome between patients with HFrEF and HFpEF. |
| ArticleNumber | 232 |
| Audience | Academic |
| Author | Gebreyohannes, Eyob Alemayehu Tefera, Yonas Getaye Abegaz, Tadesse Melaku Abebe, Tamrat Befekadu |
| Author_xml | – sequence: 1 givenname: Tamrat Befekadu surname: Abebe fullname: Abebe, Tamrat Befekadu email: Befekadutamrat@gmail.com organization: Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Science, University of Gondar – sequence: 2 givenname: Eyob Alemayehu surname: Gebreyohannes fullname: Gebreyohannes, Eyob Alemayehu organization: Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Science, University of Gondar – sequence: 3 givenname: Yonas Getaye surname: Tefera fullname: Tefera, Yonas Getaye organization: Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Science, University of Gondar – sequence: 4 givenname: Tadesse Melaku surname: Abegaz fullname: Abegaz, Tadesse Melaku organization: Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Science, University of Gondar |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/27871223$$D View this record in MEDLINE/PubMed |
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| Keywords | Heart failure Clinical characteristics Survival Ethiopia Ejection fraction |
| Language | English |
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| References_xml | – volume: 61 start-page: 1041 issue: 10 year: 2008 ident: 418_CR4 publication-title: Rev Esp Cardiol doi: 10.1157/13126044 – volume: 100 start-page: 755 issue: 9 year: 2011 ident: 418_CR35 publication-title: Clin Res Cardiol doi: 10.1007/s00392-011-0305-4 – volume: 15 start-page: 117 issue: 3 year: 2009 ident: 418_CR30 publication-title: Congest Heart Fail (Greenwich, Conn) doi: 10.1111/j.1751-7133.2008.00043.x – volume: 57 start-page: 45 issue: 1 year: 2004 ident: 418_CR19 publication-title: Rev Esp Cardiol doi: 10.1016/S0300-8932(04)77060-8 – volume: 341 start-page: 709 issue: 10 year: 1999 ident: 418_CR42 publication-title: N Engl J Med doi: 10.1056/NEJM199909023411001 – volume: 292 start-page: 344 issue: 3 year: 2004 ident: 418_CR23 publication-title: JAMA doi: 10.1001/jama.292.3.344 – volume: 28 start-page: 2686 issue: 21 year: 2007 ident: 418_CR12 publication-title: Eur Heart J doi: 10.1093/eurheartj/ehm379 – volume: 119 start-page: 3070 issue: 24 year: 2009 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Globally, heart failure (HF) has been recognized as one of the major cardiovascular disorder with high morbidity, mortality and considerable social... Globally, heart failure (HF) has been recognized as one of the major cardiovascular disorder with high morbidity, mortality and considerable social impact. In... Background Globally, heart failure (HF) has been recognized as one of the major cardiovascular disorder with high morbidity, mortality and considerable social... |
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| SubjectTerms | Analysis Angiology Blood Transfusion Medicine Calcium channels Cardiac output Cardiac Surgery Cardiology Cardiovascular agents Care and treatment Dosage and administration Echocardiography - methods Ethiopia - epidemiology Female Follow-Up Studies Health aspects Heart failure Heart Failure - diagnosis Heart Failure - mortality Heart Failure - physiopathology Humans Hypertension Internal Medicine Male Medicine Medicine & Public Health Middle Aged Non-coronary artery cardiac disease Patient outcomes Prognosis Research Article Retrospective Studies Stroke Volume - physiology Survival Rate - trends Time Factors Ventricular Function, Left - physiology |
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| Title | Patients with HFpEF and HFrEF have different clinical characteristics but similar prognosis: a retrospective cohort study |
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