The Management and Outcome of Israeli in Comparison with European Heart Failure Hospitalized and Ambulatory Patients: Results from ESC Heart Failure Long-term Registry
2Heart Institute, Rabin Medical Center, Petah Tikva
3Heart Institute, Hadassah Medical Center, Jerusalem
4Heart institute, Baruch Padeh Medical Center, Poriya
Background: Treatment of hospitalized HF (HHF) and ambulatory chronic heart failure (CHF) patients in various countries differ.
Aim: To evaluate management and outcome of Israeli in comparison to European HHF and CHF patients included in the ESC-HF Long-Term Registry.
Methods and Results: During 5.2011-4.2013 453 Israelis and 11,973 HF patients from other countries with 1-year follow up were enrolled. There were 187 HHF and 286 CHF Israeli patients. The HHF Israeli patients were older than their CHF counterparts, included more women and co-morbidities. They were treated less frequently with guidelines recommended medications.
The Israeli HHF patients had similar all-cause 1-year mortality in comparison to the other countries HHF patients, but their cardiovascular (CV) mortality was higher. They had a significantly higher rate of all-cause and HF hospitalizations.
The Israeli CHF patients were older and has more co-morbidities. They had more prior CEIDs implanted.
|
Israel |
Other countries |
p |
P Israeli HHF vs. CHF |
|
|
HHF (n) |
178 |
4861 |
||
|
Age (Median) |
77 (70-85) |
71 (61-79) |
<0.0001 |
<0.0001 |
|
Female |
44% |
37% |
<0.0001 |
<0.0001 |
|
Diabetes |
56% |
38% |
<0.0001 |
NS |
|
HTN treatment |
92% |
63% |
<0.0001 |
<0.0001 |
|
CKD |
64% |
25% |
<0.0001 |
0.0002 |
|
Prior stroke |
23% |
13% |
<0.0001 |
0.005 |
|
CIED |
19% |
15% |
0.03 |
<0.0001 |
|
1-yr mortality |
49 (27.8%) |
1310 (27.9%) |
NS |
0.0002 |
|
CHF (n) |
289 |
7112 |
||
|
Age (Median) |
68 (60-78) |
66 (57-75) |
<0.0001 |
|
|
Female |
25% |
29% |
NS |
|
|
LVEF |
30% |
35% |
0.008 |
|
|
HTN treatment |
71% |
58% |
<0.0001 |
|
|
CKD |
46% |
17% |
<0.0001 |
|
|
Prior stroke |
11% |
9% |
NS |
|
|
CIED |
49% |
35% |
<0.0001 |
|
|
1-yr mortality |
43 (15.0%) |
569 (8.3%) |
<0.0001 |
The Israeli CHF patients had higher mortality, especially cardiovascular. They were more frequently hospitalized, both all-cause and HF hospitalization.
Conclusion: The Israeli HF patients differ in their baseline characteristics and therapeutic approach. Despite high usage of guidelines recommended treatments, especially among CHF patients, mortality, in particular in HHF patients remained high.
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