Heart failure mortality in Southeast Asian patients with left ventricular systolic dysfunction.
BACKGROUND
Prognostic indicators and mortality in multiethnic Southeast Asian patients with heart failure (HF) may be different.


RESULTS
The study population comprised 225 inpatients with HF with a left ventricular ejection fraction of 40% or less who were discharged alive. Five years later, survival and causes of death were determined. Proportionally, more Malay and Indian patients were admitted compared with Chinese patients (P < .001). There were 55.6% in New York Heart Association (NYHA) class III or IV. Ischemic heart disease was the most common cause (85.8%). At 5 years, 152 patients (67.5%) had died. Angiotensin-converting enzyme inhibitors were prescribed to 79.1% of patients on discharge. Cardiovascular causes accounted for 69.7% of deaths. Predictors of mortality include female gender (P = .046), age 70 years or more (P = .017), renal impairment (P = .008), NYHA class III or IV (P = .03), and non-use of angiotensin-converting enzyme inhibitors (P = .005). On multivariate analysis, increasing age (P = .001) and renal impairment (P = .019) were independent predictors of all-cause mortality. Cardiovascular death was more likely with NYHA class III or IV (P = .004) and renal impairment (P = .012).


CONCLUSIONS
Mortality is unusually high in this group of patients despite treatment. Greater use of evidence-based therapies in HF-management programs may arrest this trend.
Heart Institute, National University Hospital, Singapore.
Swee-Chong
SC
Seow
Ping
P
Chai
Yian-Ping
YP
Lee
Yiong-Huak
YH
Chan
Bernard W K
BW
Kwok
Tiong-Cheng
TC
Yeo
Boon-Lock
BL
Chia
D000368:Aged; D044466:Asian People; D002423:Cause of Death; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000208:ethnology / Q000401:mortality*; D006801:Humans; D007194:India / Q000208:ethnology; D008296:Malaysia / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012846:Singapore / Q000453:epidemiology; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000208:ethnology / Q000401:mortality*