Clinical characteristics, etiology, co-morbidities, treatment, and outcomes of hospitalized patients with heart failure in south china

OBJECTIVES Few studies focus on the epidemiology of Hospitalized Heart Failure in South China. We compared the characteristics, etiology, co-morbidities, treatment, and outcomes in heart failure (HF) patients with reduced ejection fraction (EF) versus HF patients with preserved EF. METHODS This is a retrospective observational study enrolled 1182 hospitalized patients (mean age: 64.5±14.6 years; female: 39.2%) with heart failure from April 7, 2011 to July 11, 2015 in NanFang Hospital, Southern Medical University. An average of 2.15 years of follow-up was performed among the 927 (82.3%) patients. RESULTS Compared with reduced EF group (EF≤40%, n=351), HF patients with preserved EF (EF > 40%, n=831) were more likely to be older, female. Coronary artery disease (33.2%) was the most common cause out of 5 causes (hypertensive heart disease 24.4%, dilated cardiomyopathy 22.4%, valvular heart disease 16.1%, other heart disease 12.8%) in Hospitalized Heart Failure patients, and the preserved EF group is more likely to have ischemic, hypentensive, valvular etiology. While anemia and renal dysfunction were the most frequent comorbidities (43.9% and 43.5%), atrial fibrillation, anemia, diabetes, stroke, were more common in the preserved EF group. Diuretics were taken in 74.5% of patients at discharge, whereas angiotensinconverting enzy (ACE) inhibitors or angiotensin II receptors (ARB), beta-blockers and aldosterone antagonists were used in 64.4%, 58.6%, and 70.9% of cases, respectively. Calcium channel blockers, Statins, Clopidogrel, Nitrates were more often prescribed to the HF patients with preserved EF. Median hospital stay was 8 days. Length of hospital stay was longer in HF patients with reduced EF than those with preserved EF (8 days vs 7 days, p=0.02). All-cause in-hospital death was 4.7%, no deference was observed between the two groups (4.0% vs 5.1%, p=0.431). The all-cause mortality was 10.8% at one year, 20.7% at 2 years, and 36.0% at 5 years. The HF patients with reduced EF and preserved EF experienced similar all-cause mortality. The independent predictors of all-cause death were age, BMI, serum sodium, Serum uric acid, serum albumin, anemia, thyroid dysfunction, liver dysfunction. CONCLUSIONS There are some similarities as well as differences between the HF patients with reduced EF and preserved EF. The study provides an evidence-based epidemiology of Hospitalized Heart Failure patients in South China, which will benefit us a lot in the clinical practice.