NSAIDs: non-steroidal anti-inflammatory drugs, ACS: acute coronary syndrome

NSAIDs: non-steroidal anti-inflammatory drugs, ACS: acute coronary syndrome. Table 1 Baseline characteristics, clinical management, and outcomes

Characteristics Total (n=5625) Survivor (n=5356) In-hospital death (n=269) p

Demographics?Age (years)68.514.568.414.570.514.40.013*?Male (%) mass index (m/kg2)23.33.923.33.922.83.80.026*Co-morbidities (%)?Hypertension62.<0.001??Ischemic heart disease42.942.158.4<0.001??Atrial fibrillation28.528.723.40.059??Chronic lung disease11.311.015.60.021??Cerebrovascular disease15. renal failure14.314.020.80.002?Etiology?Ischemic CMP37.636.853.5<0.0001??Hypertensive CMP4. dilated CMP15.315.510.00.015?Clinical status on admission and discharge?De novo HF (%)52.252.349.80.423??Lung congestion (%)78.978.390.3<0.001??SBP at admission (mmHg)131.230.3131.930.1115.329.7<0.001*?SBP at discharge (mmHg)114.817.6114.817.6--?DBP at admission (mmHg)78.618.879.018.669.920.2<0.001*?DBP at discharge (mmHg)67.111.567.111.5--?Heart rate at admission (/min)92.626.092.525.895.528.30.051*?Heart rate at discharge (/min)76.814.276.814.2--?NYHA class III-IV (%) at admission84.884.493.7<0.001??NYHA class III-IV (%) at discharge10.810.8-ECG and echocardiography (%)?RBBB7.16.812.6<0.001??LBBB5. IVCD6.25.714.9<0.001??LVEF37.715.637.915.632.615.9<0.001*Management (%)?Parenteral Disodium (R)-2-Hydroxyglutarate diuretics74.974.485.9<0.001??Parenteral inotropes31.128.485.1<0.001??Parenteral vasodilators40.940.843.50.376??ACEIs/ARBs at admission38.238.532.70.056??ACEIs/ARBs at discharge65.968.8<0.001??Beta-blockers at admission28.328.622.70.035??Beta-blockers at discharge49.952.2<0.001??AAs at admission18.818.817.80.695??AAs at discharge44.946.6<0.001??Warfarin at discharge28.329.5<0.001??Heart transplantation1. of hospital stay (days)9 (1, 311)9 (1, 311)12 (1, 305)<0.001*?Total cost per admission (US dollars)ll9672.220969.28682.317787.029462.550030.4<0.001*?Patient liability costs (US dollars)3047.56007.72843.85533.27119.111341.5<0.001*?In-hospital mortality (%)4.8 Open in a separate window Values are presented as meanstandard deviation, median (min, max) or n (%). etiology (37.6%) and aggravating factor (26.3%). Angiotensin converting enzyme inhibitors/angiotensin receptor blockers, beta-blockers, and aldosterone antagonists were prescribed in 68.8%, 52.2%, and 46.6% of the patients at discharge, respectively. Compared with the previous registry performed in Korea a decade ago, extracorporeal membrane oxygenation (ECMO) and heart transplantation have been performed more frequently (ECMO 0.8% vs. 2.8%, heart transplantation 0.3% vs. 1.2%), and in-hospital mortality decreased from 7.6% to 4.8%. However, the total cost of hospital care increased by 40%, and one-year follow-up mortality remained high. Conclusion While the quality of acute clinical care and AHF-related outcomes have improved over the last decade, the long-term prognosis of heart Disodium (R)-2-Hydroxyglutarate failure is still poor in Korea. Therefore, additional research is needed to improve long-term outcomes and implement cost-effective care. Keywords: Heart failure, acute heart failure; Mortality; Guideline adherence; Quality of health care; Treatment outcome Introduction Heart failure (HF) is a major global health problem, with a prevalence of more than 26 million annual cases worldwide.1),2) Disodium (R)-2-Hydroxyglutarate The prevalence is increasing in many countries due to aging societies, increased prevalence of risk factors, and better survival from other cardiovascular diseases.3),4),5) However, the survival rate of HF remains poor, and the health burden from this condition is increasing globally.6),7),8),9),10),11),12),13) The impact of this condition has increased in Korea due to the increased growth and development of the society. The prevalence of risk factors such as diabetes, myocardial infarction, and ischemic heart disease has increased in the past few decades, although the survival outcomes from these diseases have also improved.14),15),16) Consequently, the prevalence of HF approximately doubled from 0.75% in 2002 to 0.53% in 2013, and the total medical cost increased by about 50% from 2009 to 2013.17),18) The increase in total medical cost was mostly attributable to the cost of in-hospital care. Unfortunately, the serial registry studies performed in Korea revealed that the survival from HF has not significantly improved during the past decades.11),19),20) This revealed an unmet need for a robust investigation of the PIP5K1C demographic and clinical profiles, diagnostic and therapeutic approaches in routine practice, and the degree of adherence to clinical guidelines regarding pharmacological and non-pharmacological treatments. In addition, it also suggests the need for close examination of patients’ clinical outcomes, prognostic factors, and trends over the last decade. Therefore, we established a robust registry of acute heart failure (AHF) in Korea and compared it with our previous registry. Subjects and Methods Patients and data collection The Korean Acute Heart Failure (KorAHF) registry is a prospective Disodium (R)-2-Hydroxyglutarate multicenter cohort study designed to describe patient demographics, clinical characteristics, current treatments, and short-term and long-term patient outcomes of AHF. Detailed information on the study design and results from interim analysis are described in our previous paper.20) Briefly, patients who had signs or symptoms of HF and met one of the following criteria were eligible for this study: 1) lung congestion or 2) objective left ventricular systolic dysfunction or structural heart disease findings. Patients hospitalized for AHF from one of 10 tertiary university hospitals throughout the country Disodium (R)-2-Hydroxyglutarate were consecutively enrolled from March 2011 to February 2014. Follow-up of the patients is planned until 2018. Data were collected by each site and entered into a web-based case-report form in the web-based Clinical REsearch and Trial (iCreaT) system from the Korea National Institute of Health. Information about patient demographics, medical history, signs, symptoms, laboratory test results, electrocardiogram, echocardiography, medications, hospital course, and outcomes was collected at admission, at discharge, and during the.