Prognosis of patients with heart failure and reduced ejection fraction in China

The present study aimed to investigate the 5-year survival and medication status of patients with chronic heart failure (HF) and reduced ejection fraction (HFrEF) in China. This study is a single-center, retrospective study and patients with HF and a left ventricular ejection fraction (LVEF) of ≤45%, were consecutively enrolled. The study population of 685 patients was divided into two groups, namely, LVEF ≤35 (n=371) and LVEF 36-45% (n=314). The patients were followed up for a median of 31 months (range, 8-61 months) and during this period, 24% of patients receiving angiotension-converting enzyme inhibitor/angiotensin receptor blocker (ACEI/ARB) treatment and 23% of those receiving β-blockers reached the maximum tolerated dose. Of the 191 total mortalities (28%), 127 were due to pump failure (19%) and 42 (6%) were sudden deaths. A Cox proportional hazards regression model was used to identify the variables associated with the risk of mortality. Kaplan-Meier curves and log-rank tests were used to compare the survival times of patients in the LVEF ≤35% and LVEF of 36-45% groups. The predictors of all-cause mortality were advanced age, body mass index, New York Heart Association functional class and lack of oral β-blockers at discharge. Patients with HFrEF have poor prognoses in China, particularly those patients with an LVEF of ≤35%. Therefore, cardiologists should strive to improve the prognosis of HF among Chinese patients and focus on the importance of the practical application of HF diagnosis and treatment guidelines.