One-Year Outcomes of Acute Decompensated Systolic Heart Failure in Taiwan: Lessons from TSOC-HFrEF Registry.
BACKGROUND
Heart failure (HF) is a global health problem. The Taiwan Society of Cardiology-Heart Failure with reduced Ejection Fraction (TSOC-HFrEF) registry was a multicenter, observational survey of patients admitted with HFrEF in Taiwan. The aim of this study was to report the one-year outcome in this large-cohort of hospitalized patients presenting with acute decompensated HFrEF.


METHODS
Patients hospitalized for acute HFrEF were recruited in 21 hospitals in Taiwan. A total of 1509 patients were enrolled into the registry by the end of October 2014. Clinical status, readmission rates and dispensed medications were collected and analyzed 1 year after patient index hospitalization.


RESULTS
Our study indicated that re-hospitalization rates after HFrEF were 31.9% and 38.5% at 6 and 12 months after index hospitalization, respectively. Of these patients, 9.7% of them were readmitted more than once. At 6 and 12 months after hospital discharge, all-cause mortality rates were 9.5% and 15.9%, respectively, and cardiovascular mortality rates were 6.8% and 10.5%, respectively. Twenty-three patients (1.5%) underwent heart transplantation. During a follow-up period of 1 year, 46.4% of patients were free from mortality, HF re-hospitalization, left ventricular assist device use and heart transplantation. At the conclusion of follow-up, 57.5% of patients were prescribed either with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers; also, 66.3% were prescribed with beta-blockers and 40.8% were prescribed with mineralocorticoid receptor antagonists.


CONCLUSIONS
The TSOC-HFrEF registry showed evidence of suboptimal practice of guideline-directed medical therapy and high HF re-hospitalization rate in Taiwan. The one-year mortality rate of the TSOC-HFrEF registry remained high. Ultimately, our data indicated a need for further improvement in HF care.
Heart Center, Cheng Hsin General Hospital and Faculty of Medicine, School of Medicine, National Yang Ming University, Taipei.
Hung-Yu
HY
Chang
Division of Cardiology, Chang Gung Memorial Hospital, Linkou.
Chun-Chieh
CC
Wang
Cardiology Division of Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City.
Yen-Wen
YW
Wu
Division of Cardiology, Chang Gung Memorial Hospital, Linkou.
Pao-Hsien
PH
Chu
Cardiovascular Center, National Taiwan University Hospital, Hsinchu Branch, Hsinchu.
Chih-Cheng
CC
Wu
Institute of Clinical Medicine, National Cheng Kung University, College of Medicine, National Cheng Kung University, Tainan.
Chih-Hsin
CH
Hsu
Division of Cardiology, Chang Gung Memorial Hospital, Linkou.
Ming-Shien
MS
Wen
Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung.
Wen-Chol
WC
Voon
Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital and National Defense Medical Center, Taipei.
Wei-Shiang
WS
Lin
Cardiovascular Center, Taichung Veterans General Hospital, Taichung.
Jin-Long
JL
Huang
Section of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung.
Shyh-Ming
SM
Chen
Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung.
Ning-I
NI
Yang
Division of Cardiology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City.
Heng-Chia
HC
Chang
Division of Cardiovascular Medicine and Cardiovascular Research Laboratory, China Medical University Hospital, Taichung.
Kuan-Cheng
KC
Chang
Division of Cardiology, Taipei Veterans General Hospital.
Shih-Hsien
SH
Sung
Division of Cardiology, Shin Kong Wu Ho-Su Memorial Hospital.
Kou-Gi
KG
Shyu
Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei.
Jiunn-Lee
JL
Lin
Division of Cardiology, Kaohsiung Veterans General Hospital, Kaohsiung.
Guang-Yuan
GY
Mar
Department of Internal Medicine, Chung-Shan Medical University Hospital, Taichung.
Kuei-Chuan
KC
Chan
Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei.
Jen-Yuan
JY
Kuo
Division of Cardiology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien.
Ji-Hung
JH
Wang
Division of Cardiovascular Medicine, Chimei Medical Center, Tainan.
Zhih-Cherng
ZC
Chen
Division of Cardiology, Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan.
Wei-Kung
WK
Tseng
Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung.
Wen-Jin
WJ
Cherng
Heart Center, Cheng Hsin General Hospital and Faculty of Medicine, School of Medicine, National Yang Ming University, Taipei.
Wei-Hsian
WH
Yin
Beta-blocker; Heart failure; Mortality; Renin-angiotensin blockade ; Taiwan; Treatment