News | Heart Failure | May 24, 2017

Heart Failure Mortality Inversely Related to Wealth of Country

Study finds death rates in India and Africa were three to four times higher than those documented in Western countries

Heart Failure Mortality Inversely Related to Wealth of Country

May 24, 2017 — Death in patients with heart failure is inversely related to the wealth of the country they live in, according to late breaking results from the INTERCHF study presented at Heart Failure 2017 and the 4th World Congress on Acute Heart Failure, April 29-May 2 in Paris, France. Death rates in India and Africa were three to four times higher than those documented in Western countries.

“Heart failure is a common condition that causes morbidity and mortality worldwide,” said lead author Hisham Dokainish, M.D., a principal investigator at the Population Health Research Institute (PHRI), McMaster University, Hamilton, Canada.

“Most data on heart failure have come from Western countries but the majority of the world’s population lives elsewhere,” he continued. “This study was conducted to fill large gaps in knowledge about congestive heart failure in non-Western countries.”

The International Congestive Heart Failure (INTERCHF) study was an observational cohort study that enrolled 5,823 patients with heart failure in 16 countries grouped into six regions: Africa (Mozambique, Nigeria, South Africa, Sudan, Uganda), China, India, the Middle East (Egypt, Qatar, Saudi Arabia), Southeast Asia (Malaysia, the Philippines) and South America (Argentina, Chile, Colombia and Ecuador).

Data on each patient was collected at baseline, six months and one year and entered into the electronic data management system at PHRI. Baseline data included demographics (age, sex), cardiac and non-cardiac factors (previous heart attack or stroke, duration of congestive heart failure, diabetes mellitus, renal failure, chronic obstructive pulmonary disease), medications, socioeconomic factors (education level, literacy, employment, urban/rural setting) and heart failure aetiology.

At six months and one year data was collected on the frequency and cause of any hospitalizations in the previous six months. Information was also recorded on death and cause of death. The investigators calculated death rates in each region and adjusted for 20 variables that included demographic, clinical and socioeconomic factors, medications and cause of heart failure.

The overall all-cause mortality rate for the entire study population was 17 percent. It was highest in Africa (34 percent) and India (23 percent), intermediate in Southeast Asia (15 percent), and lowest in the Middle East (9 percent), South America (9 percent) and China (7 percent).

Dokainish said, “Mortality in patients with heart failure was inversely related to the wealth of the country. The poorer the country, the higher the mortality, and the richer the country, the lower the mortality.”

“In Western countries the one-year mortality rate for patients with heart failure is 5–10 percent,” he added. “We’re finding two to three times that death rate in African and Indian patients.”

“We were very surprised by the much higher mortality rates,” he continued. “You could say maybe the patients in Africa or India were sicker, or didn’t take their medicines, or had poorer heart function, but we adjusted for all of those things and don’t really understand why their death rates were so much higher.”

The researchers hypothesized that variables not measured in the study contributed to the high death rates, such as access to and quality of healthcare, and cardiac biomarkers. These variables will be measured in the next phase of the research program, the Global Congestive Heart Failure (G-CHF) study, which aims to recruit 25,000 heart failure patients from all inhabited continents and income levels. Genetic analyses will also be conducted in a G-CHF substudy.

Dokainish said, “INTERCHF has shown that there are large differences in the risk of heart failure patients dying at one year depending on where they live. We hope to discover why these differences exist through the G-CHF study. If that identifies barriers to receiving care that are due to the way a healthcare system is structured, access to healthcare or quality of healthcare, then that would need to be addressed.”

For more information: www.escardio.org

Related Content

New FDA Proposed Rule Alters Informed Consent for Clinical Studies
News | Cardiovascular Clinical Studies | November 19, 2018
The U.S. Food and Drug Administration (FDA) is proposing to add an exception to informed consent requirements for...
A key slide from Elnabawi's presentation, showing cardiac CT plaque evaluations, showing the impact of psoriasis medication on coronary plaques at baseline and one year of treatment. It shows a reversal of vulnerable plaque development. #SCAI, #SCAI2018

A key slide from Elnabawi's presentation, showing cardiac CT plaque evaluations, showing the impact of psoriasis medication on coronary plaques at baseline and one year of treatment. It shows a reversal of vulnerable plaque development.  

Feature | Cardiovascular Clinical Studies | May 14, 2018
May 14, 2018 – New clinical evidance shows common therapy options for psoriasis (PSO), a chronic inflammatory skin di
Intravenous Drug Use is Causing Rise in Heart Valve Infections, Healthcare Costs. #SCAI, #SCAI2018
News | Cardiovascular Clinical Studies | May 14, 2018
May 14, 2018 — The opioid drug epidemic is impacting cardiology, with a new study finding the number of patients hosp
Patient Enrollment Completed in U.S. IDE Study of THERMOCOOL SMARTTOUCH SF Catheter
News | Cardiovascular Clinical Studies | March 15, 2018
March 15, 2018 –  Johnson & Johnson Medical Devices Companies announced today that Biosense Webster, Inc., who wo
Lexington Begins HeartSentry Clinical Trial
News | Cardiovascular Clinical Studies | February 20, 2018
February 20, 2018 – Lexington Biosciences, Inc., a development-stage medical device company, announced the commenceme
Endologix Completes Patient Enrollment in the ELEVATE IDE Clinical Study
News | Cardiovascular Clinical Studies | February 06, 2018
February 6, 2018 – Endologix, a developer and marketer of treatments for aortic disorders, announced the completion o
12-Month Results from Veryan Medical's MIMICS-2 IDE Study Presented at LINC
News | Cardiovascular Clinical Studies | February 01, 2018
February 1, 2018 – Thomas Zeller (Bad Krozingen, Germany) presented the 12-month results from Veryan Medical’s MIMICS
LimFlow Completes U.S. Feasibility Study Enrollment, Receives FDA Device Status
News | Cardiovascular Clinical Studies | February 01, 2018
February 1, 2018 –  LimFlow SA, developer of minimally-inv
ESC 2017 late breaking trial hot line study presentations.
News | Cardiovascular Clinical Studies | September 12, 2017
September 12, 2017 – The European Society of Cardiology (ESC) Congress 2017 includes several Hot Line Late-breaking C
U.K., NHS studies, weekend effect, hospital admission, atrial fibrillation, heart failure
News | Cardiovascular Clinical Studies | June 28, 2016
New research shows patients admitted to National Health Service (NHS) hospitals in the United Kingdom for atrial...
Overlay Init