Byung Su Yoo, MD., PhD. Division of Cardiology, Wonju College of Medicine, Yonsei University, South Korea Differences in clinical characteristics and its effect for outcomes between western and Korean patients with ADHF : ACC 2015: Advances in the care of patients with heart failure
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Differences in clinical characteristics and its effect for outcomes
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Byung Su Yoo, MD., PhD.
Division of Cardiology, Wonju College of Medicine,
Yonsei University, South Korea
Differences in clinical characteristics
and its effect for outcomes
between western and Korean patients
with ADHF :
ACC 2015: Advances in the care of patients with heart failure
Outlines : What’s difference ?
Background
Comparisons of Acute Heart Failure Registry
Outcomes and other clinical analysis
Summary
: the prevalence of heart failure has been rapidly increasing in worldwide and its
influence on mortality, morbidity and the cost of health care is growing fast.
Heart failure is epidemic in worldwide
Heart
Failure ↑
Aging
Society
Advanced medical & surgical
care
IHD, DM etc.
Background
Comparisons of HF prevalence
Estimated Prevalence of heart failure by age group
(National Health Insurance Service’s sample cohort
database, 2010, Korea).
Prevalence of heart failure by sex and age (National
Health and Nutrition Examination Survey: 2009–
2012). Source: National Center for Health Statistics
and National Heart, Lung, and Blood Institute. USA
0.8
3.8
9.4
0.8
4.7
9.5
0
2
4
6
8
10
40-59 60-79 80+
Pre
va
len
ce
Age
Men Women
0.2
1.5
6.6
10.6
0.6 1.2
4.8
13.5
0
2
4
6
8
10
12
14
16
20-39 40-59 60-79 80+
Pre
va
len
ce
of P
op
ula
tio
n
Age (Years)
Background
Trends of heart failure in Korea Heart failure is rapidly increasing, especially in old age
2009 y 2010 y 2011 y 2012 y 2013 y
Total 94,421 100,480 109,588 114,393 115,063
Male 32,989 36,334 41,010 42,935 44,330
Female 61,432 64,146 68,578 71,458 70,733
(number of total HF patients)
Total 0-9 YO 10-19 YO 20-29 YO 30-39 YO 40-49 YO 50-59 YO 60-69 YO 70-79YO ≥80 YO
Male 176 3 3 8 25 70 338 462 1,179 2,744
Female 285 3 3 7 22 52 159 506 1,622 3,362
(number of HF patients per 100,000 population)
*In Korea, annually in average, 230 patients/100,000 population visit clinic or hospital due to any causes
**HF patients (≥ 80 YO) visit hospital 14 times frequently compared to general population
National Health Insurance database, 2014, Korea
Background
0.0
0.5
1.0
1.5
2.0
2002 2003 2004 2005 2006 2007 2008 2009 2010
Pre
va
len
ce
(%
)
Year
Men
Women
0.75%
1.06%
1990 2000 2010 2020 2030 2040 2050
Aging is global issue
Trends in aged population according to nation 2012. UN
Prevalence of heart failure by sex in 2002-
2010 (Source : National Health Insurance
Service’s sample cohort database)
0%
10%
20%
30%
40%
USA
Italy
India
China
Japan
Korea
Background
• Average age: 55-65 years vs. 65~70
• Women: 20-25% vs. 50%
• Ischemia etiology (CAD): ≈ 50% vs. ≈ 50%
• Renal insufficiency: usually excluded
(mean Cr 1.1-1.3) vs. 30%
• Preserved LV systolic function: usually excluded (LVEF usually <35-
40) vs. ≈ 50%
• Atrial fibrillation: < 25% vs. >30%
Characteristics of ADHF Patients
Enrolled in Clinical Trials vs. Registry
We need a registry data to evaluate characteristics, clinical profiles