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Wan Ahmad WA, Abdul Ghapar AK, Zainal Abidin HA, Karthikesan D, Ross NT, S.K. Abdul Kader MA, Loch A, Mahendran K, Ramli AW, Ong TK, Mohd Amin NH, Lee CY, Che Hassan HH, Zainal Abidin SK, Liew HB, Ho WS, Mohd Ghazi A. Characteristics of patients admitted with heart failure: Insights from the first Malaysian Heart Failure Registry. ESC Heart Fail 2024; 11:727-736. [PMID: 38131217 PMCID: PMC10966232 DOI: 10.1002/ehf2.14608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 10/25/2023] [Accepted: 11/16/2023] [Indexed: 12/23/2023] Open
Abstract
AIMS Heart failure (HF) is a growing health problem, yet there are limited data on patients with HF in Malaysia. The Malaysian Heart Failure (MY-HF) Registry aims to gain insights into the epidemiology, aetiology, management, and outcome of Malaysian patients with HF and identify areas for improvement within the national HF services. METHODS AND RESULTS The MY-HF Registry is a 3-year prospective, observational study comprising 2717 Malaysian patients admitted for acute HF. We report the description of baseline data at admission and outcomes of index hospitalization of these patients. The mean age was 60.2 ± 13.6 years, 66.8% were male, and 34.3% had de novo HF. Collectively, 55.7% of patients presented with New York Heart Association (NYHA) Class III or IV; ischaemic heart disease was the most frequent aetiology (63.2%). Most admissions (87.3%) occurred via the emergency department, with 13.7% of patients requiring intensive care, and of these, 21.8% needed intubation. The proportion of patients receiving guideline-directed medical therapy increased at discharge (84.2% vs. 93.6%). The median length of stay (LOS) was 5 days, and in-hospital mortality was 2.9%. Predictors of LOS and/or in-hospital mortality were age, NYHA class, estimated glomerular filtration rate, and comorbid anaemia. LOS and in-hospital mortality were similar regardless of ejection fraction. CONCLUSIONS The MY-HF Registry showed that the HF population in Malaysia is younger, predominantly male, and ischaemic-driven and has good prospects with hospitalization for optimization of treatment. These findings suggest a need to reassess current clinical practice and guide resource allocation to improve patient outcomes.
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Affiliation(s)
- Wan Azman Wan Ahmad
- Department of MedicineUniversity of Malaya Medical CentreKuala LumpurMalaysia
| | | | | | - Dharmaraj Karthikesan
- Department of MedicineHospital Sultanah Bahiyah, Ministry of Health MalaysiaKedahMalaysia
| | - Noel Thomas Ross
- Department of MedicineHospital Kuala Lumpur, Ministry of Health MalaysiaKuala LumpurMalaysia
| | | | - Alexander Loch
- Department of MedicineUniversity of Malaya Medical CentreKuala LumpurMalaysia
| | - Kauthaman Mahendran
- Department of General Medicine and Clinical Research CentreHospital Melaka, Ministry of Health MalaysiaMelakaMalaysia
| | - Ahmad Wazi Ramli
- Department of CardiologyHospital Sultanah Nur Zahirah, Ministry of Health MalaysiaTerengganuMalaysia
| | - Tiong Kiam Ong
- Department of CardiologySarawak Heart Centre, Ministry of Health MalaysiaSarawakMalaysia
| | - Nor Hanim Mohd Amin
- Department of CardiologyHospital Raja Permaisuri Bainun, Ministry of Health MalaysiaPerakMalaysia
| | - Chuey Yan Lee
- Department of CardiologyHospital Sultanah Aminah, Ministry of Health MalaysiaJohorMalaysia
| | - Hamat Hamdi Che Hassan
- Department of CardiologyHospital Universiti Kebangsaan Malaysia, Ministry of Health MalaysiaKuala LumpurMalaysia
| | | | - Houng Bang Liew
- Department of CardiologyHospital Queen Elizabeth II, Ministry of Health MalaysiaSabahMalaysia
| | - Wing Sze Ho
- Department of Medical AffairsNovartis Corporation (Malaysia) Sdn BhdPetaling JayaMalaysia
| | - Azmee Mohd Ghazi
- Department of CardiologyNational Heart Institute of MalaysiaKuala LumpurMalaysia
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Eysenbach G, Noh MFM, Ismail SR, van Daalen KR, Kamaruddin PSNM, Zulkiply SH, Azizul NH, Khalid NM, Ali A, Idris IM, Mei YS, Abdullah SR, Faridus N, Yusof NAM, Yusoff NNFM, Jamal R, Rahim AAA, Ghapar AKA, Radhakrishnan AK, Fong AYY, Ismail O, Krishinan S, Lee CY, Bang LH, Mageswaren E, Mahendran K, Amin NHM, Muthusamy G, Jin AOH, Ramli AW, Ross NT, Ruhani AI, Yahya M, Yusoff Y, Abidin SKZ, Amado L, Bolton T, Weston S, Crawte J, Ovenden N, Michielsen A, Monower MM, Mahiyuddin WRW, Wood A, Di Angelantonio E, Sulaiman NS, Danesh J, Butterworth AS. Investigating Genetic and Other Determinants of First-Onset Myocardial Infarction in Malaysia: Protocol for the Malaysian Acute Vascular Events Risk Study. JMIR Res Protoc 2022; 11:e31885. [PMID: 35142634 PMCID: PMC8874931 DOI: 10.2196/31885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 10/01/2021] [Accepted: 10/06/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Although the burden of premature myocardial infarction (MI) is high in Malaysia, direct evidence on the determinants of MI in this multi-ethnic population remains sparse. OBJECTIVE The Malaysian Acute Vascular Events Risk (MAVERIK) study is a retrospective case-control study established to investigate the genomic, lipid-related, and other determinants of acute MI in Malaysia. In this paper, we report the study protocol and early results. METHODS By June 2019, we had enrolled approximately 2500 patients with their first MI and 2500 controls without cardiovascular disease, who were frequency-matched by age, sex, and ethnicity, from 17 hospitals in Malaysia. For each participant, serum and whole blood have been collected and stored. Clinical, demographic, and behavioral information has been obtained using a 200-item questionnaire. RESULTS Tobacco consumption, a history of diabetes, hypertension, markers of visceral adiposity, indicators of lower socioeconomic status, and a family history of coronary disease were more prevalent in cases than in controls. Adjusted (age and sex) logistic regression models for traditional risk factors indicated that current smoking (odds ratio [OR] 4.11, 95% CI 3.56-4.75; P<.001), previous smoking (OR 1.34, 95% CI 1.12-1.60; P=.001), a history of high blood pressure (OR 2.13, 95% CI 1.86-2.44; P<.001), a history of diabetes mellitus (OR 2.72, 95% CI 2.34-3.17; P<.001), a family history of coronary heart disease (OR 1.28, 95% CI 1.07-1.55; P=.009), and obesity (BMI >30 kg/m2; OR 1.19, 95% CI 1.05-1.34; P=.009) were associated with MI in age- and sex-adjusted models. CONCLUSIONS The MAVERIK study can serve as a useful platform to investigate genetic and other risk factors for MI in an understudied Southeast Asian population. It should help to hasten the discovery of disease-causing pathways and inform regionally appropriate strategies that optimize public health action. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR1-10.2196/31885.
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Affiliation(s)
| | - Mohd Fairulnizal Md Noh
- Institute for Medical Research, National Institute of Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - Sophia Rasheeqa Ismail
- Institute for Medical Research, National Institute of Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - Kim Robin van Daalen
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | | | - Siti Hafizah Zulkiply
- Institute for Medical Research, National Institute of Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - Nur Hayati Azizul
- Institute for Medical Research, National Institute of Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - Norhayati Mustafa Khalid
- Institute for Medical Research, National Institute of Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - Azizan Ali
- Institute for Medical Research, National Institute of Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - Izyan Mohd Idris
- Institute for Medical Research, National Institute of Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - Yong Shih Mei
- Institute for Medical Research, National Institute of Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - Shazana Rifham Abdullah
- Institute for Medical Research, National Institute of Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - Norfashihah Faridus
- Institute for Medical Research, National Institute of Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - Nur Azirah Md Yusof
- Institute for Medical Research, National Institute of Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - Nur Najwa Farahin M Yusoff
- Institute for Medical Research, National Institute of Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - Rahman Jamal
- UKM Medical Molecular Biological Institute, Kuala Lumpur, Malaysia
| | | | | | - Ammu Kutty Radhakrishnan
- Jeffery Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
| | - Alan Yean Yip Fong
- Department of Cardiology, Sarawak Heart Centre, Kota Samarahan, Malaysia.,Clinical Research Centre, Institute for Clinical Research, Sarawak General Hospital, Kuching, Malaysia
| | - Omar Ismail
- Department of Cardiology, Hospital Pulau Pinang, Pulau Pinang, Malaysia
| | | | - Chuey Yan Lee
- Department of Cardiology, Hospital Sultanah Aminah, Johor, Malaysia
| | - Liew Houng Bang
- Department of Cardiology & Clinical Research Centre, Hospital Queen Elizabeth II, Sabah, Malaysia
| | - Eashwary Mageswaren
- Department of General Medicine, Hospital Tengku Ampuan Rahimah, Selangor, Malaysia
| | - Kauthaman Mahendran
- Department of General Medicine & Clinical Research Centre, Hospital Melaka, Melaka, Malaysia
| | - Nor Hanim Mohd Amin
- Department of General Medicine, Hospital Raja Permaisuri Bainun, Perak, Malaysia
| | | | - Aaron Ong Hean Jin
- Department of General Medicine, Hospital Tuanku Fauziah, Perlis, Malaysia
| | - Ahmad Wazi Ramli
- Department of Cardiology, Hospital Sultanah Nur Zahirah, Terengganu, Malaysia
| | - Noel Thomas Ross
- Department of General Medicine, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | | | - Mansor Yahya
- Institute for Medical Research, National Institute of Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - Yusniza Yusoff
- Department of General Medicine, Hospital Sungai Buloh, Selangor, Malaysia
| | | | - Laryssa Amado
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Thomas Bolton
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.,National Institute for Health Research Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, Cambridge, United Kingdom
| | - Sophie Weston
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Jason Crawte
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Niko Ovenden
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Ank Michielsen
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Md Mostafa Monower
- National Heart Foundation Hospital & Research Institute, Mirpur, Dhaka, Bangladesh
| | - Wan Rozita Wan Mahiyuddin
- Institute for Medical Research, National Institute of Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - Angela Wood
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.,National Institute for Health Research Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, Cambridge, United Kingdom.,Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, United Kingdom.,British Heart Foundation Centre of Research Excellence, University of Cambridge, Cambridge, United Kingdom
| | - Emanuele Di Angelantonio
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.,National Institute for Health Research Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, Cambridge, United Kingdom.,Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, United Kingdom.,British Heart Foundation Centre of Research Excellence, University of Cambridge, Cambridge, United Kingdom
| | - Nur Suffia Sulaiman
- Institute for Medical Research, National Institute of Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - John Danesh
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.,National Institute for Health Research Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, Cambridge, United Kingdom.,Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, United Kingdom.,British Heart Foundation Centre of Research Excellence, University of Cambridge, Cambridge, United Kingdom.,Department of Human Genetics, Wellcome Sanger Institute, Hinxton, United Kingdom
| | - Adam S Butterworth
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.,National Institute for Health Research Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, Cambridge, United Kingdom.,Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, United Kingdom.,British Heart Foundation Centre of Research Excellence, University of Cambridge, Cambridge, United Kingdom
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