{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T18:37:46Z","timestamp":1793385466690,"version":"4.5.0"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"21","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,11,7]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The management of heart failure (HF) has markedly changed, due to changes in demographics and the emergence of novel pharmacotherapies. However, detailed analyses on the temporal trends in characteristics and outcomes among patients with HF are scarcely available. This study aimed to assess the temporal trends over 11\u2009years in clinical management and outcomes in patients with HF.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We analyzed data from a multicenter registry of hospitalized patients with acute HF, including 6877 patients registered from 2011 to 2021. Age\u2010adjusted mortality was calculated using standardized mortality ratios. During the study period, mean age increased from 75.2\u2009years in 2011 to 2012 to 76.4\u2009years in 2020 to 2021 (\n              <jats:italic>P<\/jats:italic>\n              for trend &lt;0.001). The proportion of HF with reduced ejection fraction (HFrEF, left ventricular ejection fraction &lt;40%) remained constant (from 43.4% to 42.7%,\n              <jats:italic>P<\/jats:italic>\n              for trend=0.38). The median duration of hospital stays (from 15 to 17\u2009days,\n              <jats:italic>P<\/jats:italic>\n              for trend&lt;0.001) had increased. As for the implementation of guideline\u2010directed medical therapy, the use of mineralocorticoid receptor antagonist at discharge increased in patients with HFrEF (from 44.3% to 60.2%,\n              <jats:italic>P<\/jats:italic>\n              for trend&lt;0.001). There was also an increase in the use of sodium\u2010glucose cotransporter\u20102 inhibitors following their approval for use. The age\u2010adjusted 1\u2010year mortality decreased in patients with HFrEF (from 18.0% to 9.3%,\n              <jats:italic>P<\/jats:italic>\n              for trend&lt;0.001) but not in patients with non\u2010HFrEF (left ventricular ejection fraction \u226540%; from 9.2% to 9.5%,\n              <jats:italic>P<\/jats:italic>\n              for trend=0.79).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Hospitalized patients with HF have been aging over the past decade. Their long\u2010term outcomes after discharge have improved predominantly because of decreased mortality in patients with HFrEF.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.123.031179","type":"journal-article","created":{"date-parts":[[2023,11,6]],"date-time":"2023-11-06T11:28:54Z","timestamp":1699270134000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":31,"title":["Temporal Trends in Heart Failure Management and Outcomes: Insights From a Japanese Multicenter Registry of Tertiary Care Centers"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0129-7219","authenticated-orcid":false,"given":"Ryo","family":"Nakamaru","sequence":"first","affiliation":[{"name":"Department of Cardiology Keio University School of Medicine Tokyo Japan"},{"name":"Department of Healthcare Quality Assessment The University of Tokyo 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