Study design, baseline characteristics, and in-hospital outcomes of acute heart failure in Korea: initial report from the nationwide Korean Heart Failure III Registry

초록

Aims: We evaluated the demographics, clinical characteristics, management, and in-hospital outcomes of patients hospitalized for acute heart failure in Korea registered in the nationwide Korean Heart Failure III Registry Methods: We prospectively enrolled 7,352 patients hospitalized for acute heart failure (AHF) at 47 tertiary university hospitals in Korea from March 2018 to December 2022. We compared findings from this registry with those of other registries. Results: The mean patient age was 68.7 ± 14.9 years, 56.7% were male, and 55.1% had de novo heart failure. Mean systolic blood pressure at admission was 134.3 ± 28.7 mmHg. Left ventricular ejection fraction was ≤ 40% in 57.3% of patients. Ischaemia was the most common aetiology (27.5%). Progression of chronic heart failure was the most common aggravating factor (24.3%). Renin-angiotensin-aldosterone inhibitor, beta-blockers, mineralocorticoid antagonists, and sodium-glucose cotransporter-2 inhibitors were prescribed in 72.2%, 69.0%, 56.3%, and 15.8% at discharge, respectively. Compared to a Korean registry from a decade extracorporeal membrane oxygenation and heart transplantation were now performed less commonly (2.8% vs. 0.9% and 1.2% vs. 0.7%, respectively), whereas left ventricular assist device implantation was performed more frequently (0.1% vs. 0.7%). In-hospital mortality decreased from 4.8% to 1.6%. Total hospital care cost had increased by only 10%. Conclusions: This nationwide registry study revealed unique characteristics and outcomes in Korean patients with AHF. The prescription rate of neurohormonal blockades in Korea is lower than that in other developed countries. This highlights the need for further research to improve physicians' adherence to the guidelines.