title: Temporal trends in clinical characteristics, management and prognosis of patients with symptomatic heart failure in Japan -- report from the CHART Studies.
abstract: BACKGROUND
  Temporal trends in clinical characteristics, management and prognosis of patients with symptomatic heart failure (HF) remain to be elucidated in Japan.
  
  
  RESULTS
  From the Chronic Heart Failure Analysis and Registry in the Tohoku District-1 (CHART-1; 2000-2005, n=1,278) and CHART-2 (2006-present, n=10,219) Studies, we enrolled 1,006 and 3,676 consecutive symptomatic stage C/D HF patients, respectively. As compared with the patients in the CHART-1 Study, those in the CHART-2 Study had similar age and sex prevalence, and were characterized by lower brain natriuretic peptide, higher prevalence of preserved left ventricular ejection fraction (LVEF) and higher prevalence of hypertension, diabetes mellitus and ischemic heart disease (IHD), particularly IHD with LVEF ≥50%. From CHART-1 to CHART-2, use of renin-angiotensin system inhibitors, β-blockers and aldosterone antagonists was significantly increased, while that of loop diuretics and digitalis was decreased. Three-year incidences of all-cause death (24 vs. 15%; adjusted hazard ratio [adjHR], 0.73; P<0.001), cardiovascular death (17 vs. 7%; adjHR, 0.38; P<0.001) and hospitalization for HF (30 vs. 17%; adjHR, 0.51; P<0.001) were all significantly decreased from CHART-1 to CHART-2. In the CHART-2 Study, use of β-blockers was associated with improved prognosis in patients with LVEF <50%, while that of statins was associated with improved prognosis in those with LVEF ≥50%.
  
  
  CONCLUSIONS
  Along with implementation of evidence-based medications, the prognosis of HF patients has been improved in Japan. (
  
  
  BACKGROUND
  clinicaltrials.gov identifier: NCT00418041)
authors.affiliation: Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine.
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Ushigome
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Sakata
authors.forename: Kotaro
authors.initials: K
authors.lastname: Nochioka
authors.forename: Satoshi
authors.initials: S
authors.lastname: Miyata
authors.forename: Masanobu
authors.initials: M
authors.lastname: Miura
authors.forename: Soichiro
authors.initials: S
authors.lastname: Tadaki
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yamauchi
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Sato
authors.forename: Takeo
authors.initials: T
authors.lastname: Onose
authors.forename: Kanako
authors.initials: K
authors.lastname: Tsuji
authors.forename: Ruri
authors.initials: R
authors.lastname: Abe
authors.forename: Takuya
authors.initials: T
authors.lastname: Oikawa
authors.forename: Shintaro
authors.initials: S
authors.lastname: Kasahara
authors.forename: Jun
authors.initials: J
authors.lastname: Takahashi
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shimokawa
mesh_terms: D000368:Aged; D002317:Cardiovascular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015897:Comorbidity; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D007564:Japan; D053208:Kaplan-Meier Estimate; D008297:Male; D015995:Prevalence; D016016:Proportional Hazards Models; D012042:Registries; D012307:Risk Factors; D013318:Stroke Volume / Q000187:drug effects; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000187:drug effects
chemical_list: D002317:Cardiovascular Agents