title: Clinical characteristics and long-term clinical outcomes of Japanese heart failure patients with preserved versus reduced left ventricular ejection fraction: a prospective cohort of Shinken Database 2004-2011.
abstract: BACKGROUND
  Clinical data on the mortality and morbidity of unselected Japanese patients with heart failure (HF) are limited. In this study, we aimed to determine the clinical characteristics, long-term outcomes, and prognostic factors of Japanese HF patients with preserved or reduced left ventricular ejection fraction (LVEF).
  
  
  RESULTS
  We used a single hospital-based cohort from the Shinken Database 2004-2011 that comprised all new patients (n=17,517) visiting the Cardiovascular Institute Hospital. A total of 1,525 patients diagnosed with symptomatic HF at the initial visit were included in the analysis. Of these, 1121 patients (74%) exhibited a preserved LVEF (>50%) and 404 patients (26%) had a reduced LVEF (≤ 50%). HF patients with preserved LVEF (HFpEF) were older and more often female than patients with reduced LVEF (HFrEF). Kaplan-Meier curves and log-rank test results showed that HFpEF patients had a better prognosis than HFrEF patients. However, there were no significant differences in clinical outcomes between HFpEF and HFrEF patients when the analysis was limited to inpatients. Cox regression analysis showed that HFpEF patients had a significantly lower risk of all-cause death (p=0.027; hazard ratio, 0.547, 95% confidence interval, 0.321-0.933). Multivariate analyses performed separately showed that the independent predictors of all-cause death in HFrEF were advanced age, lower body mass index, diabetes mellitus, and the absence of statin treatment, whereas those for HFpEF were advanced age, absence of dyslipidemia, anemia, and left ventricular hypertrophy.
  
  
  CONCLUSIONS
  This prospective cohort study identified the clinical characteristics, long-term outcomes, and prognostic factors of Japanese HF patients with reduced and preserved ejection fractions in a real-world clinical setting.
authors.affiliation: Cardiovascular Institute, Tokyo, Japan. h-kaneko@cvi.or.jp
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Kaneko
authors.forename: Shinya
authors.initials: S
authors.lastname: Suzuki
authors.forename: Junji
authors.initials: J
authors.lastname: Yajima
authors.forename: Yuji
authors.initials: Y
authors.lastname: Oikawa
authors.forename: Koichi
authors.initials: K
authors.lastname: Sagara
authors.forename: Takayuki
authors.initials: T
authors.lastname: Otsuka
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Matsuno
authors.forename: Hiroto
authors.initials: H
authors.lastname: Kano
authors.forename: Tokuhisa
authors.initials: T
authors.lastname: Uejima
authors.forename: Akira
authors.initials: A
authors.lastname: Koike
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Nagashima
authors.forename: Hajime
authors.initials: H
authors.lastname: Kirigaya
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Sawada
authors.forename: Tadanori
authors.initials: T
authors.lastname: Aizawa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yamashita
mesh_terms: D000367:Age Factors; D000368:Aged; D044466:Asian People; D002423:Cause of Death; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006333:Heart Failure / Q000401:mortality / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012737:Sex Factors; D013318:Stroke Volume; D013997:Time Factors; D016277:Ventricular Function, Left
keywords: Heart failure; Japanese; Preserved ejection fraction; Prognosis