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Polypill Eligibility for Patients with Heart Failure with Reduced Ejection Fraction in the ASIAN-HF Registry: A Cross-Sectional Analysis Cover

Polypill Eligibility for Patients with Heart Failure with Reduced Ejection Fraction in the ASIAN-HF Registry: A Cross-Sectional Analysis

Global Heart
Volume 18 (2023): Issue 1
By: Aishwarya Vijay,  Wan Ting Tay,  Tiew-Hwa K. Teng,  Kanako Teramoto,  Jasper Tromp,  Wouter Ouwerkerk,  Seet Yoong Lo,  Wataru Shimizu,  Mark D. Huffman,  Carolyn S. P. Lam,  Chanchal Chandramouli and  Anubha Agarwal  
Open Access
|Jun 2023
Figures & tables

Figures & Tables

Table 1

Baseline characteristics of patients with HFrEF who were eligible or not eligible for HFrEF polypill therapy.

BASELINE CHARACTERISTICSELIGIBLE FOR HFrEF POLYPILL N = 2611NOT ELIGIBLE FOR HFrEF POLYPILL N = 1105p-VALUE
N (%)2611 (70.3%)1105 (29.7%)
Age at baseline, years, mean (SD)60.8 (13.0)62.1 (13.1)0.005
Men2086 (79.9%)829 (75.0%)<0.001
NYHA class<0.001
    I374 (16.0%)98 (9.9%)
    II1262 (54.1%)534 (54.2%)
    III600 (25.7%)288 (29.2%)
    IV97 (4.2%)66 (6.7%)
BMI, kg/m224.3 (21.8, 27.8)23.6 (20.7, 26.5)<0.001
Systolic BP, mmHg120 (110, 131)102 (92, 124)<0.001
Diastolic BP, mmHg72.0 (66, 80)65 (58, 73)<0.001
Heart rate, bpm80.0 (70, 90)75 (66, 86)<0.001
LVEF at baseline, %27 (21, 33)27 (21, 33)0.51
eGFR, mL/min/1.73 m266.5 (51.2, 84.6)44.9 (24.1, 71.9)<0.001
Potassium, mmol/L4.1 (3.8, 4.5)4.4 (4.0, 5.1)<0.001
Etiology of HF
    Ischemic1322 (50.7%)580 (52.5%)0.21
    Non-Ischemic1131 (43.3%)474 (42.9%)
    Unknown156 (6.0%)51 (4.6%)
Diabetes1218 (46.6%)542 (49.0%)0.18
Coronary artery disease1340 (51.3%)626 (56.7%)<0.01
Hypertension1477 (56.6%)600 (54.3%)0.19
Atrial fibrillation/flutter506 (19.4%)240 (21.7%)0.10
Peripheral arterial disease96 (3.7%)52 (4.7%)0.14
ACE-inhibitor1422 (54.9%)488 (44.4%)<0.001
ARB804 (31.1%)277 (25.2%)<0.001
ACEi or ARB2105 (81.3%)726 (66.0%)<0.001
Beta-blocker2073 (80.1%)863 (78.5%)0.26
MRA1513 (58.5%)547 (49.7%)<0.001
Geographical bloc<0.001
    Northeast Asia712 (27.3%)368 (33.3%)
    South Asia587 (22.5%)257 (23.3%)
    Southeast Asia1312 (50.2%)480 (43.4%)
Ethnicity<0.001
    Chinese714 (27.3%)258 (23.3%)
    Indian719 (27.5%)299 (27.1%)
    Malay470 (18.0%)165 (14.9%)
    Japanese/Korean523 (20.0%)282 (25.5%)
    Thai/Filipino/Others185 (7.1%)101 (9.1%)
Regional income level0.78
    Low773 (29.6%)336 (30.4%)
    Middle333 (12.8%)146 (13.2%)
    High1505 (57.6%)623 (56.4%)

[i] NYHA: New York Heart Association; BMI: body mass index; BP: blood pressure; LVEF: left ventricular ejection fraction; eGFR: estimated glomerular filtration rate; MDRD: modification of diet in renal disease; HF: heart failure; ACEi: angiotensin converting enzyme inhibitor; ARB: angiotensin receptor blocker; MRA: mineralocorticoid receptor antagonist.

Figure 1

Prescription of individual and combined components of guideline directed medical therapy, triple therapy, and eligibility for HFrEF polypill by sex (a), geographic bloc (b), regional income level (c).

Table 2

Association of sociodemographic and geographic factors with HFrEF polypill eligibility.

NELIGIBLE FOR HFrEF POLYPILLUNADJUSTED OR (95% CI)p-VALUEADJUSTED* OR (95% CI)p-VALUE
Sex
    Men29152086 (71.6%)1.00 (Ref)1.00 (Ref)
    Women801525 (65.5%)0.76 (0.64, 0.89)0.0010.77 (0.65, 0.91)<0.01
Geographical bloc
    Northeast Asia1080712 (65.9%)0.85 (0.70, 1.03)0.090.82 (0.61, 1.09)0.17
    South Asia844587 (69.6%)1.00 (Ref)1.00 (Ref)
    Southeast Asia17921312 (73.2%)1.20 (1.00, 1.43)0.051.01 (0.70, 1.46)0.97
Regional income level
    Low1109773 (69.7%)0.95 (0.81, 1.12)0.551.05 (0.77, 1.44)0.74
    Middle479333 (69.5%)0.94 (0.76, 1.17)0.600.99 (0.68, 1.43)0.94
    High21281505 (70.7%)1.00 (Ref)1.00 (Ref)
Region
    Hong Kong5035 (70.0%)1.02 (0.55, 1.90)0.950.95 (0.43, 2.14)0.91
    India844587 (69.6%)1.00 (Ref)1.00 (Ref)
    Indonesia213148 (69.5%)1.00 (0.72, 1.38)0.990.88 (0.54, 1.43)0.61
    Japan538328 (61.0%)0.68 (0.54, 0.86)0.0010.64 (0.43, 0.93)0.02
    Korea268196 (73.1%)1.19 (0.88, 1.62)0.261.11 (0.72, 1.71)0.65
    Malaysia291221 (76.0%)1.38 (1.02, 1.88)0.041.23 (0.79, 1.92)0.36
    Philippines5238 (73.1%)1.19 (0.63, 2.23)0.591.00 (0.48, 2.11)0.99
    Singapore1,048793 (75.7%)1.36 (1.11, 1.67)<0.011.17 (0.82, 1.68)0.38
    Taiwan224153 (68.3%)0.94 (0.69, 1.30)0.720.86 (0.55, 1.35)0.51
    Thailand188112 (59.6%)0.65 (0.47, 0.89)<0.010.59 (0.36, 0.97)0.04

[i] * Adjusted for age and sex, and site-level clustering using a random effect.

DOI: https://doi.org/10.5334/gh.1215 | Journal eISSN: 2211-8179
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Language: English
Submitted on: Feb 28, 2023
Accepted on: May 26, 2023
Published on: Jun 15, 2023
Published by: Ubiquity Press
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year
Keywords:
polypill,
HFrEF,
global cardiovascular health,
ASIAN-HF,
guideline-directed medical therapy

© 2023 Aishwarya Vijay, Wan Ting Tay, Tiew-Hwa K. Teng, Kanako Teramoto, Jasper Tromp, Wouter Ouwerkerk, Seet Yoong Lo, Wataru Shimizu, Mark D. Huffman, Carolyn S. P. Lam, Chanchal Chandramouli, Anubha Agarwal, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.

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