Table 2.
Baseline characteristics of 629 440 contemporary patients with heart failure across 11 countries between 2018 and 2020
| Belgium | Canada | Germany*† | Israel | Italy | Norway | Portugal | Spain | Sweden | Switzerland* | UK | Pooled baseline (95% CI) |
Tau | |
| No of patients | 2379 | 23 953 | 63 712 | 9759 | 67 369 | 76 561 | 3681 | 21 851 | 180 727 | 14 204 | 165 244 | n/a | n/a |
| Index year | 2018 | 2019 | 2019 | 2020 | 2018 | 2020 | 2019 | 2019 | 2019 | 2019 | 2020 | ||
| Age (years) (mean (SD)) | 72 (17) | 75 (14) | 75 (12) | 74 (13) | 78 (12) | 74 (13) | 78 (12) | 78 (11) | 75 (13) | 74 (13) | 74 (13) | 75.2 (74.0 to 76.4) | 2.00 |
| Women (n (%)) | 932 (39) | 11 993 (50) | 27 892 (44) | 3681 (38) | 33 987 (50) | 30 746 (40) | 2171 (59) | 10 261 (47) | 77 791 (43) | 5612 (40) | 71 862 (43) | 44.8 (41.1 to 48.6) | 6.29 |
| NYHA functional classification (n (%)) | |||||||||||||
| I | 101 (9) | n/a | 2810 (5) | n/a | n/a | n/a | n/a | 2781 (13) | n/a | 436 (8) | 8768 (32) | 13.4 (3.8 to 23.0) | 10.92 |
| II | 472 (43) | n/a | 15 427 (27) | n/a | n/a | n/a | n/a | 9716 (45) | n/a | 1532 (27) | 12 668 (47) | 37.7 (29.0 to 46.4) | 9.94 |
| III | 419 (38) | n/a | 25 441 (45) | n/a | n/a | n/a | n/a | 8172 (38) | n/a | 2299 (40) | 5427 (20) | 36.2 (27.8 to 44.5) | 9.48 |
| IV | 105 (10) | n/a | 13 398 (23) | n/a | n/a | n/a | n/a | 821 (4) | n/a | 1446 (25) | 358 (1) | 12.7 (3.0 to 22.4) | 11.10 |
| Ischaemic heart disease (n (%)) | 1424 (60) | 13 850 (58) | 33 711 (53) | 5812 (60) | 19 720 (29) | 41 933 (55) | 1546 (42) | 4769 (22) | 87 152 (48) | n/a | 70 379 (43) | 48.8 (40.9 to 56.8) | 12.16 |
| Myocardial infarction (n (%)) | 883 (37) | 7042 (29) | 13 041 (20) | 3132 (32) | 7665 (11) | 23 160 (30) | 673 (18) | 3130 (14) | 62 768 (35) | n/a | 45 022 (27) | 25.5 (20.0 to 31.0) | 8.84 |
| Unstable angina (n (%)) | 9 (0) | 6126 (26) | 3399 (5) | 299 (3) | 2624 (4) | n/a | 437 (12) | 1034 (5) | 20 255 (11) | n/a | 5118 (3) | 7.7 (2.7 to 12.7) | 7.69 |
| Angina pectoris (n (%)) | 764 (32) | 13 282 (55) | 2978 (5) | 256 (3) | 19 080 (28) | 37 117 (48) | 1296 (35) | 1735 (8) | 63 302 (35) | n/a | 30 119 (18) | 26.8 (15.6 to 38.1) | 18.15 |
| Stroke (n (%)) | 428 (18) | 4133 (17) | 5112 (8) | 1147 (12) | 7297 (11) | 2298 (3) | 466 (13) | 2401 (11) | 28 415 (16) | n/a | 29 805 (18) | 12.6 (9.6 to 15.6) | 4.82 |
| Atrial fibrillation/flutter (n (%)) | 1258 (53) | 11 886 (50) | 29 675 (47) | 4144 (42) | 20 655 (31) | 39 544 (52) | 1482 (40) | 7246 (33) | 95 330 (53) | n/a | 67 552 (41) | 44.1 (39.1 to 49.0) | 7.97 |
| Peripheral artery disease (n (%)) | 236 (10) | 2729 (11) | 6547 (10) | 332 (3) | 5115 (8) | 7881 (10) | 216 (6) | 1050 (5) | 14 010 (8) | n/a | 11 985 (7) | 7.8 (6.2 to 9.5) | 2.62 |
| Diabetes (n (%)) | 865 (36) | 10 549 (44) | 21 564 (34) | 4868 (50) | 25 103 (37) | 16 039 (21) | 1540 (42) | 7371 (34) | 45 134 (25) | 3922 (28) | 48 533 (29) | 34.5 (29.4 to 39.6) | 8.61 |
| CKD diagnosis (n (%)) | 1515 (64) | 9766 (41) | 34 784 (55) | 6146 (63) | 11 082 (16) | 21 398 (28) | 898 (24) | 6143 (28) | 32 669 (18) | 6389 (45) | 60 331 (37) | 38.0 (28.0 to 48.0) | 16.91 |
| Cancer (n (%)) | 439 (18) | 3271 (14) | 1798 (3) | 2437 (25) | 7665 (11) | 19 637 (26) | 956 (26) | 2417 (11) | 53 011 (29) | n/a | 20 830 (13) | 17.6 (12.2 to 22.9) | 8.61 |
| Disease modifying HF drug treatment (n (%)) | 2379 (100) | 18 547 (77) | 5529 (95) | 9039 (93) | 56 895 (84) | 65 470 (86) | 3020 (82) | 19 407 (89) | 163 686 (91) | n/a | 150 758 (91) | 88.7 (84.7 to 92.8) | 6.56 |
| RAAS inhibitor (n (%)) | 1445 (61) | 13 827 (58) | 5007 (86) | 6697 (69) | 43 575 (65) | 50 879 (66) | 1837 (50) | 14 446 (66) | 132 989 (74) | 8409 (59) | 117 198 (71) | 65.8 (60.3 to 71.3) | 9.36 |
| ACE inhibitor (n (%)) | 1368 (58) | 9174 (38) | 2578 (44) | 3488 (36) | 23 926 (36) | 30 913 (40) | 1380 (37) | 6840 (31) | 74 681 (41) | 5746 (40) | 81 713 (49) | 41.0 (36.8 to 45.3) | 7.19 |
| ARB (n (%)) | 77 (3) | 4653 (19) | 1938 (33) | 3738 (38) | 23 033 (34) | 21 653 (28) | 487 (13) | 7606 (35) | 62 741 (35) | 3363 (24) | 40 177 (24) | 26.1 (19.8 to 32.5) | 10.77 |
| Beta blocker (n (%)) | 1914 (80) | 13 541 (57) | 4944 (85) | 7940 (81) | 36 842 (55) | 56 186 (73) | 1939 (53) | 15 160 (69) | 142 418 (79) | 8823 (62) | 113 060 (68) | 69.3 (62.5 to 76.1) | 11.46 |
| MRA (n (%)) | 2077 (87) | 2942 (12) | 1878 (32) | 3389 (35) | 15 474 (23) | 12 828 (17) | 452 (12) | 6816 (31) | 50 363 (28) | n/a | 40 299 (24) | 30.2 (16.8 to 43.6) | 21.59 |
| Sacubitril–valsartan (n (%)) | 138 (6) | 185 (1) | 595 (10) | n/a | 593 (1) | 2678 (3) | 41 (1) | 1632 (7) | 3887 (2) | 509 (4) | 5003 (3) | 3.8 (1.9 to 5.7) | 3.08 |
| SGLT-2i (n (%)) | 39 (2) | 568 (2) | 268 (5) | 840 (9) | 499 (1) | 2472 (3) | 73 (2) | 797 (4) | 3677 (2) | 164 (1) | 3086 (2) | 2.9 (1.6 to 4.2) | 2.18 |
| Other HF treatments (n (%)) | |||||||||||||
| Loop diuretics | 1360 (57) | 12 548 (52) | 4077 (70) | 5948 (61) | 37 532 (56) | 34 688 (45) | 1964 (53) | 15 680 (72) | 95 881 (53) | n/a | 85 769 (52) | 57.1 (52.0 to 62.3) | 8.24 |
| Digoxin | 591 (25) | 2095 (9) | 8 (0) | 556 (6) | 6851 (10) | 5221 (7) | n/a | 1676 (8) | 19 338 (11) | n/a | 19 842 (12) | 9.6 (5.3 to 13.9) | 6.61 |
| Device therapy* | n/a | 1145 (5) | 1021 (2) | 1683 (17) | 460 (1) | 7429 (10) | n/a | 1430 (7) | 28 702 (16) | 768 (5) | 20 036 (12) | 8.2 (4.3 to 12.1) | 5.92 |
| Nitrates (n (%)) | 77 (3) | 2999 (13) | 107 (2) | 975 (10) | 5805 (9) | 10 177 (13) | 443 (12) | 2411 (11) | 37 700 (21) | n/a | 32 047 (19) | 11.3 (7.5 to 15.0) | 6.02 |
| Warfarin (n (%)) | 648 (27) | 3331 (14) | 1108 (19) | 834 (9) | 11 107 (16) | 9786 (13) | 227 (6) | 4096 (19) | 39 739 (22) | n/a | 26 196 (16) | 16.0 (12.2 to 19.9) | 6.15 |
| Receptor P2Y12 antagonists (n (%)) | 627 (26) | 2782 (12) | 1563 (27) | 2092 (21) | 7636 (11) | 7722 (10) | 274 (7) | 2137 (10) | 15 040 (8) | n/a | 22 768 (14) | 14.7 (10.1 to 19.2) | 7.32 |
Random effect estimates were used to calculate pooled values and tau describes the estimated SD of underlying data across countries.
*Patients identified following a first hospitalisation for heart failure in a specified time period in Germany and Switzerland due to data availability, during 2019 and 2015–2019, respectively
†Laboratory and drug treatment data from one hospital, Leipzig Heart Centre, Leipzig, Germany.
ACE, angiotensin converting enzyme; ARB, angiotensin receptor blockers; CKD, chronic kidney disease; HF, heart failure; MRA, mineralocorticoid receptor antagonist; n/a, not available; NYHA, New York Heart Association; RAAS, renin–angiotensin–aldosterone system inhibitor; SGLT-2i, sodium–glucose cotransporter 2 inhibitors.