Nobuhisa Hagiwara
   Department   Other, Other
   Position  
Article types Original article
Language English
Peer review Peer reviewed
Title Chronic obstructive pulmonary disease and β-blocker treatment in Asian patients with heart failure.
Journal Formal name:ESC heart failure
Abbreviation:ESC Heart Fail
ISSN code:2055-5822
Domestic / ForeginForegin
Publisher The Heart Failure Association of the European Society of Cardiology
Volume, Issue, Page 5(2),pp.297-305
Author and coauthor Kubota Yoshiaki, Tay Wan Ting, Asai Kuniya, Murai Koji, Nakajima Ikutaro, Hagiwara Nobuhisa, Ikeda Takanori, Kurita Takashi, Teng Tiew-Hwa Katherine, Anand Inder, Lam Carolyn S P, Shimizu Wataru,
Publication date 2018/04
Summary AIMS:
Chronic obstructive pulmonary disease (COPD) and heart failure (HF) are increasingly frequent in Asia and commonly coexist in patients. However, the prevalence of COPD among Asian patients with HF and its impact on HF treatment are unclear.

METHODS AND RESULTS:
We compared clinical characteristics and treatment approaches between patients with or without a history of COPD, before and after 1:2 propensity matching (for age, sex, geographical region, income level, and ethnic group) in 5232 prospectively recruited patients with HF and reduced ejection fraction (HFrEF, <40%) from 11 Asian regions (Northeast Asia: South Korea, Japan, Taiwan, Hong Kong, and China; South Asia: India; Southeast Asia: Thailand, Malaysia, Philippines, Indonesia, and Singapore). Among the 5232 patients with HFrEF, a history of COPD was present in 8.3% (n = 434), with significant variation in geography (11.0% in Northeast Asia vs. 4.7% in South Asia), regional income level (9.7% in high income vs. 5.8% in low income), and ethnicity (17.0% in Filipinos vs. 5.2% in Indians) (all P < 0.05). Use of mineralocorticoid receptor antagonists and diuretics was similar between groups, while usage of all β-blockers was lower in the COPD group than in the non-COPD group in the overall (66.3% vs. 79.9%) and propensity-matched cohorts (66.3% vs. 81.7%) (all P < 0.05). A striking exception was the Japanese cohort in which β-blocker use was high in COPD and non-COPD patients (95.2% vs. 91.2%).

CONCLUSIONS:
The prevalence of COPD in HFrEF varied across Asia and was related to underuse of β-blockers, except in Japan.
DOI 10.1002/ehf2.12228
PMID 29055972