{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T03:21:09Z","timestamp":1781839269455,"version":"3.54.5"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T00:00:00Z","timestamp":1764892800000},"content-version":"vor","delay-in-days":1282,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2022,6,2]],"date-time":"2022-06-02T00:00:00Z","timestamp":1654128000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Novartis Corporation (Malaysia) Sdn. Bhd"},{"DOI":"10.13039\/100009010","name":"Novartis Pharmaceuticals UK Limited","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009010","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Heart failure (HF) affects an estimated 38 million people worldwide and is the leading cause of hospitalization among adults and the elderly. Evidence suggests that there may be regional and ethnic differences in the prevalence, outcomes and management of HF. The aim of this study was to understand the disease burden and treatment patterns of patients hospitalized for HF in multi-ethnic Malaysia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>A retrospective, non-interventional study was conducted utilizing 10 years of medical records from the National Heart Institute Malaysia (IJN) from 1 January 2009 to 31 December 2018. Of the 4739 patients in the IJN database, 3923 were eligible and were included in this analysis. The study recorded a high male prevalence (72.3%) with a mean age of 62.0 (\u00b113.26) years. The 30-day and 1-year rehospitalization rate was 6.8% and 24.7%, respectively. In-hospital mortality was 7.2% with 27.0% due to cardiovascular causes and 14.2% non-cardiovascular causes. The 30-day and 1-year rehospitalization rates were significantly higher in patients with lower systolic blood pressure (SBP, P &amp;lt; 0.001 and P = 0.002), diastolic blood pressure (DBP, P &amp;lt; 0.001 and P = 0.017), sodium (P &amp;lt; 0.001 and P = 0.029) and estimated glomerular filtration rate (eGFR, P &amp;lt; 0.001 and P = 0.002) and higher urea (P &amp;lt; 0.001 for both), serum creatinine (P &amp;lt; 0.001 and P = 0.003), and uric acid (P &amp;lt; 0.001 for both), respectively. Risk of hospitalization within 1 year varied significantly by ethnicity and was relatively higher in Indian (28.3%), followed by Malay (24.4%) and Chinese (21.9%; P = 0.008). In-hospital mortality within 1-year post-index date was higher in patients with lower weight (P = 0.002), body mass index (P = 0.009), SBP (P &amp;lt; 0.001), DBP (P &amp;lt; 0.001), sodium (P &amp;lt; 0.001), eGFR (P &amp;lt; 0.001) and higher heart rate (P = 0.039), urea (P &amp;lt; 0.001), serum potassium (P = 0.038), serum creatinine (P &amp;lt; 0.001), and uric acid (P &amp;lt; 0.001). In-hospital mortality within 1-year post-index date was also higher in patients with severe or end-stage chronic kidney disease (CKD) compared with mild\/moderate CKD (P &amp;lt; 0.001) and in patients with HF with reduced ejection fraction (HFrEF) compared with those with mid-range or preserved ejection fraction (P &amp;lt; 0.001). The most commonly prescribed HF medications at discharge were loop diuretics (89.2%), \u03b2-blockers (68.5%), mineralocorticoid receptor antagonists (56.2%), angiotensin-converting enzyme inhibitors (31.5%), and angiotensin receptor blockers (20.8%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study provides a greater understanding of the characteristics, treatment patterns, and outcome of hospitalized HF patients in a leading referral centre in Malaysia and will aid the implementation of meaningful interventions to improve patient outcome for HF patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.13992","type":"journal-article","created":{"date-parts":[[2022,6,2]],"date-time":"2022-06-02T05:40:15Z","timestamp":1654148415000},"page":"2664-2675","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Patient Profiles on Outcomes in Patients Hospitalized for Heart Failure: A 10-Year History of the Malaysian Population"],"prefix":"10.1093","volume":"9","author":[{"given":"Azmee","family":"Mohd Ghazi","sequence":"first","affiliation":[{"name":"National Heart Institute , Kuala Lumpur ,","place":["Malaysia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chee Kiang","family":"Teoh","sequence":"additional","affiliation":[{"name":"National Heart Institute , Kuala Lumpur ,","place":["Malaysia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aizai Azan","family":"Abdul Rahim","sequence":"additional","affiliation":[{"name":"National Heart Institute , Kuala Lumpur ,","place":["Malaysia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,6,2]]},"reference":[{"key":"2026012114150986000_ehf213992-bib-0001","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1016\/j.cardfail.2021.01.022","article-title":"Universal definition and classification of heart failure: A report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and writing committee of the Universal Definition of Heart Failure","volume":"27","author":"Bozkurt","year":"2021","journal-title":"J Card Fail"},{"key":"2026012114150986000_ehf213992-bib-0002","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1093\/eurjhf\/hfs105","article-title":"ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012","volume":"14","author":"Mcmurray","year":"2012","journal-title":"Eur J Heart Fail"},{"key":"2026012114150986000_ehf213992-bib-0003","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1016\/j.jacc.2013.11.053","article-title":"The global health and economic burden of hospitalizations for heart failure lessons learned from hospitalized heart failure registries","volume":"63","author":"Ambrosy","year":"2014","journal-title":"J Am Coll Cardiol"},{"key":"2026012114150986000_ehf213992-bib-0004","doi-asserted-by":"crossref","first-page":"1727","DOI":"10.1136\/hrt.2008.150177","article-title":"Epidemiology and clinical management of cardiomyopathies and heart failure in China","volume":"95","author":"Jiang","year":"2009","journal-title":"Heart"},{"key":"2026012114150986000_ehf213992-bib-0005","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1016\/S0140-6736(14)61889-4","article-title":"The war against heart failure: The Lancet lecture","volume":"385","author":"Braunwald","year":"2015","journal-title":"Lancet"},{"key":"2026012114150986000_ehf213992-bib-0006","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1038\/nrcardio.2010.165","article-title":"Epidemiology and risk profile of heart failure","volume":"8","author":"Bui","year":"2011","journal-title":"Nat Rev Cardiol"},{"key":"2026012114150986000_ehf213992-bib-0007","doi-asserted-by":"crossref","first-page":"2163","DOI":"10.1016\/S0140-6736(12)61729-2","article-title":"Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990\u20132010: A systematic analysis for the Global Burden of Disease Study 2010","volume":"380","author":"Global Burden of Disease Study 2010","year":"2012","journal-title":"Lancet"},{"key":"2026012114150986000_ehf213992-bib-0008","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1016\/S1388-9842(03)00013-8","article-title":"Heart failure in a multiethnic population in Kuala Lumpur","volume":"5","author":"Chong","year":"2003","journal-title":"Malaysia Eur J Heart Fail"},{"key":"2026012114150986000_ehf213992-bib-0009","doi-asserted-by":"crossref","first-page":"1999","DOI":"10.1016\/S1071-9164(99)91585-3","article-title":"Heart failure hospitalizations in Malaysia","volume":"5","author":"Teh","year":"1999","journal-title":"J Card Fail"},{"key":"2026012114150986000_ehf213992-bib-0010","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1016\/j.ijcard.2013.12.028","article-title":"The annual global economic burden of heart failure","volume":"171","author":"Cook","year":"2014","journal-title":"Int J Cardiol"},{"key":"2026012114150986000_ehf213992-bib-0011","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1016\/j.jacc.2008.10.041","article-title":"Acute heart failure syndromes","volume":"53","author":"Gheorghiade","year":"2009","journal-title":"J Am Coll Cardiol"},{"key":"2026012114150986000_ehf213992-bib-0012","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1161\/HHF.0b013e318291329a","article-title":"Forecasting the impact of heart failure in the United States: A policy statement from the American Heart Association","volume":"6","author":"Heidenreich","year":"2013","journal-title":"Circ Heart Fail"},{"key":"2026012114150986000_ehf213992-bib-0013","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1002\/ehf2.12021","article-title":"Improving care for patients with acute heart failure: Before, during and after hospitalization","volume":"1","author":"Cowie","year":"2014","journal-title":"ESC Hear Fail"},{"key":"2026012114150986000_ehf213992-bib-0014","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1093\/eurheartj\/ehm554","article-title":"Prognosis of heart failure with preserved ejection fraction: A 5 year prospective population-based study","volume":"29","author":"Tribouilloy","year":"2008","journal-title":"Eur Heart J"},{"key":"2026012114150986000_ehf213992-bib-0015","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1161\/CIRCOUTCOMES.113.000119","article-title":"Global variation in quality of care among patients hospitalized with acute heart failure in an international trial","volume":"6","author":"Howlett","year":"2013","journal-title":"Circ Cardiovasc Qual Outcomes"},{"key":"2026012114150986000_ehf213992-bib-0016","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1161\/CIRCULATIONAHA.114.012284","article-title":"International geographic variation in event rates in trials of heart failure with preserved and reduced ejection fraction","volume":"131","author":"Kristensen","year":"2015","journal-title":"Circulation"},{"key":"2026012114150986000_ehf213992-bib-0017","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1001699","article-title":"Heart failure care in low- and middle-income countries: A systematic review and meta-analysis","volume":"11","author":"Callender","year":"2014","journal-title":"PLoS Med"},{"key":"2026012114150986000_ehf213992-bib-0018","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.ijcard.2015.01.063","article-title":"Predictors of two-year mortality in Asian patients with heart failure and preserved ejection fraction","volume":"183","author":"Yap","year":"2015","journal-title":"Int J Cardiol"},{"key":"2026012114150986000_ehf213992-bib-0019","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/j.gheart.2012.10.004","article-title":"Assessing the global burden of ischemic heart disease","volume":"7","author":"Moran","year":"2012","journal-title":"Glob Heart"},{"key":"2026012114150986000_ehf213992-bib-0020","doi-asserted-by":"crossref","first-page":"1186","DOI":"10.1016\/j.ijcard.2012.11.065","article-title":"Worldwide risk factors for heart failure: A systematic review and pooled analysis","volume":"168","author":"Khatibzadeh","year":"2013","journal-title":"Int J Cardiol"},{"key":"2026012114150986000_ehf213992-bib-0021","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1002\/ejhf.566","article-title":"European Society of Cardiology Heart Failure Long Term Registry (ESC-HF-LT): 1-year follow-up outcomes and differences across regions","volume":"18","author":"Crespo-leiro","year":"2016","journal-title":"Eur J Heart Fail"},{"key":"2026012114150986000_ehf213992-bib-0022","doi-asserted-by":"crossref","first-page":"112","DOI":"10.2174\/1573403X11309020004","article-title":"Heart failure in East Asia","volume":"9","author":"Guo","year":"2013","journal-title":"Curr Cardiol Rev"},{"key":"2026012114150986000_ehf213992-bib-0023","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/j.cardfail.2011.09.003","article-title":"Patient characteristics from a regional multicenter database of acute decompensated heart failure in Asia Pacific (ADHERE International-Asia Pacific)","volume":"18","author":"Atherton","year":"2012","journal-title":"J Card Fail"},{"key":"2026012114150986000_ehf213992-bib-0024","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12872-020-01793-7","article-title":"Acute decompensated heart failure in a non-cardiology tertiary referral centre, Sarawak General Hospital (SGH-HF)","volume":"20","author":"Ling","year":"2020","journal-title":"BMC Cardiovasc Disord"},{"key":"2026012114150986000_ehf213992-bib-0025","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1177\/2010105820978664","article-title":"Acute heart failure\u2013The \u201creal\u201d Malaysian experience: An observational study from a single non-cardiac centre","volume":"30","author":"Raja Shariff","year":"2021","journal-title":"Proc Singapore Healthc"},{"key":"2026012114150986000_ehf213992-bib-0026","doi-asserted-by":"crossref","first-page":"3141","DOI":"10.1093\/eurheartj\/ehw331","article-title":"Regional and ethnic differences among patients with heart failure in Asia: The Asian sudden cardiac death in heart failure registry","volume":"37","author":"Lam","year":"2016","journal-title":"Eur Heart J"},{"key":"2026012114150986000_ehf213992-bib-0027","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/j.ijcard.2016.07.256","article-title":"Heart failure across Asia: Same healthcare burden but differences in organization of care","volume":"223","author":"Reyes","year":"2016","journal-title":"Int J Cardiol"},{"key":"2026012114150986000_ehf213992-bib-0028","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.120.018696","article-title":"Regional variations in heart failure quality and outcomes: Get With The Guidelines-Heart Failure Registry","volume":"10","author":"Cunningham","year":"2021","journal-title":"J Am Heart Assoc"},{"key":"2026012114150986000_ehf213992-bib-0029","doi-asserted-by":"crossref","first-page":"2725","DOI":"10.1093\/eurheartj\/ehl193","article-title":"EuroHeart Failure Survey II (EHFS II): A survey on hospitalized acute heart failure patients: Description of population","volume":"27","author":"Nieminen","year":"2006","journal-title":"Eur Heart J"},{"key":"2026012114150986000_ehf213992-bib-0030","doi-asserted-by":"crossref","first-page":"1991","DOI":"10.1161\/01.CIR.0000065637.10517.A0","article-title":"Uric acid and survival in chronic heart failure: Validation and application in metabolic, functional, and hemodynamic staging","volume":"107","author":"Anker","year":"2003","journal-title":"Circulation"},{"key":"2026012114150986000_ehf213992-bib-0031","doi-asserted-by":"crossref","first-page":"928","DOI":"10.1016\/j.ahj.2010.08.006","article-title":"Uric acid level and allopurinol use as risk markers of mortality and morbidity in systolic heart failure","volume":"160","author":"Wu","year":"2010","journal-title":"Am Heart J"},{"key":"2026012114150986000_ehf213992-bib-0032","doi-asserted-by":"crossref","first-page":"1713","DOI":"10.1016\/j.amjcard.2014.09.008","article-title":"Relation of serum uric acid levels and outcomes among patients hospitalized for worsening heart failure with reduced ejection fraction (from the efficacy of vasopressin antagonism in heart failure outcome study with tolvaptan trial)","volume":"114","author":"Vaduganathan","year":"2014","journal-title":"Am J Cardiol"},{"key":"2026012114150986000_ehf213992-bib-0033","doi-asserted-by":"crossref","first-page":"1616","DOI":"10.1016\/j.amjcard.2016.02.039","article-title":"Prognostic significance of hyperuricemia in patients with acute heart failure","volume":"117","author":"Palazzuoli","year":"2016","journal-title":"Am J Cardiol"},{"key":"2026012114150986000_ehf213992-bib-0034","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/j.numecd.2017.12.009","article-title":"Elevated serum uric acid concentration at discharge confers additive prognostic value in elderly patients with acute heart failure","volume":"28","author":"Coiro","year":"2018","journal-title":"Nutr Metab Cardiovasc Dis"},{"key":"2026012114150986000_ehf213992-bib-0035","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.ejim.2021.04.001","article-title":"Serum uric acid and outcomes in patients with chronic heart failure through the whole spectrum of ejection fraction phenotypes: Analysis of the ESC-EORP Heart Failure Long-Term (HF LT) Registry","volume":"89","author":"Ambrosio","year":"2021","journal-title":"Eur J Intern Med"}],"container-title":["ESC Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ehf2.13992","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ehf2.13992","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/9\/4\/2664\/65349120\/eschf_9_4_2664.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/9\/4\/2664\/65349120\/eschf_9_4_2664.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T19:17:58Z","timestamp":1769023078000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eschf\/article\/9\/4\/2664\/8322987"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,2]]},"references-count":35,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,6,2]]},"published-print":{"date-parts":[[2022,8,1]]}},"URL":"https:\/\/doi.org\/10.1002\/ehf2.13992","relation":{},"ISSN":["2055-5822"],"issn-type":[{"value":"2055-5822","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,8]]},"published":{"date-parts":[[2022,6,2]]},"assertion":[{"value":"2022-02-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-05-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-06-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}