Repositorio UFRO · Omeka S

Global Variations in Heart Failure Etiology, Management, and Outcomes

Primer Autor	Yusuf, Salim
Co-autores	Joseph, Philip Roy, Ambuj Lonn, Eva Stoerk, Stefan Floras, John Mielniczuk, Lisa Rouleau, Jean-Lucien Zhu, Jun Dzudie, Anastase Balasubramanian, Kumar Karaye, Kamilu AlHabib, Khalid F. Gomez-Mesa, Juan Esteban Branch, Kelley R. Makubi, Abel Budaj, Andrzej Avezum, Alvaro Wittlinger, Thomas Ertl, Georg Mondo, Charles Pogosova, Nana Maggioni, Aldo Pietro Orlandini, Andres Parkhomenko, Alexander ElSayed, Ahmed Lopez-Jaramillo, Patricio Grinvalds, Alex Temizhan, Ahmet Hage, Camilla Lund, Lars H. Kazmi, Khawar Lanas, Fernando Sharma, Sanjib Kumar Fox, Keith McMurray, John J. V. Leong, Darryl Dokainish, Hisham Khetan, Aditya Yonga, Gerald Kragholm, Kristian Shaker, Kerolos Wagdy Mwita, Julius Chacha Al Mulla, Arif Abudullatif Alla, Francois Damasceno, Albertino Silva-Cardoso, Jose Dans, Antonio L. Sliwa, Karen O'Donnell, Martin Bazargani, Nooshin Bayes-Genis, Antoni McCready, Tara Probstfield, Jeffrey
Título	Global Variations in Heart Failure Etiology, Management, and Outcomes
Editorial	AMER MEDICAL ASSOC
Revista	JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
Lenguaje	en
Resumen	Importance Most epidemiological studies of heart failure (HF) have been conducted in high-income countries with limited comparable data from middle- or low-income countries. Objective To examine differences in HF etiology, treatment, and outcomes between groups of countries at different levels of economic development. Design, Setting, and Participants Multinational HF registry of 23341 participants in 40 high-income, upper-middle-income, lower-middle-income, and low-income countries, followed up for a median period of 2.0 years. Main Outcomes and Measures HF cause, HF medication use, hospitalization, and death. Results Mean (SD) age of participants was 63.1 (14.9) years, and 9119 (39.1%) were female. The most common cause of HF was ischemic heart disease (38.1%) followed by hypertension (20.2%). The proportion of participants with HF with reduced ejection fraction taking the combination of a beta-blocker, renin-angiotensin system inhibitor, and mineralocorticoid receptor antagonist was highest in upper-middle-income (61.9%) and high-income countries (51.1%), and it was lowest in low-income (45.7%) and lower-middle-income countries (39.5%) (P<.001). The age- and sex- standardized mortality rate per 100 person-years was lowest in high-income countries (7.8 [95% CI, 7.5-8.2]), 9.3 (95% CI, 8.8-9.9) in upper-middle-income countries, 15.7 (95% CI, 15.0-16.4) in lower-middle-income countries, and it was highest in low-income countries (19.1 [95% CI, 17.6-20.7]). Hospitalization rates were more frequent than death rates in high-income countries (ratio=3.8) and in upper-middle-income countries (ratio=2.4), similar in lower-middle-income countries (ratio=1.1), and less frequent in low-income countries (ratio=0.6). The 30-day case-fatality rate after first hospital admission was lowest in high-income countries (6.7%), followed by upper-middle-income countries (9.7%), then lower-middle-income countries (21.1%), and highest in low-income countries (31.6%). The proportional risk of death within 30 days of a first hospital admission was 3- to 5-fold higher in lower-middle-income countries and low-income countries compared with high-income countries after adjusting for patient characteristics and use of long-term HF therapies. Conclusions and Relevance This study of HF patients from 40 different countries and derived from 4 different economic levels demonstrated differences in HF etiologies, management, and outcomes. These data may be useful in planning approaches to improve HF prevention and treatment globally.
Fecha Publicación	2023
Tipo de Recurso	artículo original
doi	10.1001/jama.2023.5942
Formato Recurso	PDF
Palabras Claves	Aged Causality Developed Countries / economics Developed Countries / statistics & numerical data Developing Countries / economics Developing Countries / statistics & numerical data Female Global Health / statistics & numerical data Heart Failure / epidemiology Heart Failure / etiology Heart Failure / mortality Heart Failure / therapy Hospitalization / economics Hospitalization / statistics & numerical data Humans Hypertension / complications Hypertension / epidemiology Income Male Middle Aged Registries / statistics & numerical data Stroke Volume
Ubicación del archivo	http://dx.doi.org/10.1001/jama.2023.5942
Categoría OCDE	Medicina general e interna
Materias	Envejecido Causalidad Países Desarrollados / economía Países desarrollados / estadísticas y datos numéricos Países en desarrollo / economía Países en desarrollo / estadísticas y datos numéricos Femenino Salud Global / estadísticas y datos numéricos Insuficiencia Cardíaca/epidemiología Insuficiencia Cardíaca/etiología Insuficiencia Cardíaca/mortalidad Insuficiencia cardíaca/terapia Hospitalización/economía Hospitalización/estadísticas y datos numéricos Humanos Hipertensión/complicaciones Hipertensión/epidemiología Ingreso Masculino De edad mediana Registros/estadísticas y datos numéricos Volumen sistólico
Página de inicio (Recomendado-único)	1650.0
Página final (Recomendado-único)	1661
Identificador del recurso (Mandatado-único)	artículo original
Versión del recurso (Recomendado-único)	versión publicada
Derechos de acceso	acceso abierto
Access Rights	acceso abierto
Id de Web of Science	WOS:001053900200020
ISSN	0098-7484
Tipo de ruta	verde
Categoría WOS	Medicina general e interna