1.Management of atherosclerosis risk factors for patients at high cardiovascular risk in real-world practice: a multicentre study.
Arintaya PHROMMINTIKUL ; Rungroj KRITTAYAPHONG ; Wanwarang WONGCHAROEN ; Sukit YAMWONG ; Smonporn BOONYARATAVEJ ; Rapeephon KUNJARA-NA-AYUDHYA ; Pyatat TATSANAVIVAT ; Piyamitr SRITARA ; null
Singapore medical journal 2017;58(9):535-542
INTRODUCTIONAtherosclerotic cardiovascular disease is a global health burden. However, there are heterogeneities among countries or regions in the risk factors and clinical manifestations of atherosclerotic diseases as well as management patterns.
METHODSWe collected data from 25 centres in Thailand. Patients with documented coronary artery disease, cerebrovascular disease or peripheral arterial disease, or with at least three atherosclerosis risk factors were enrolled between April 2011 and March 2014. Data on demographics, atherosclerosis risk factors and the management pattern of risk factors, including laboratory findings, were recorded.
RESULTSIn total, 9,390 patients, including 4,861 patients with established atherosclerotic disease and 4,529 patients with multiple risk factors, were enrolled. The modifiable risk factors, other than current smoking habit (5.3%), were common: hypertension (83.8%), dyslipidaemia (85.9%) and diabetes mellitus (57.4%). A majority of patients with hypertension (96.3%), dyslipidaemia (93.8%) and diabetes mellitus (78.5%) received medications for their conditions. Antiplatelet agents were given to 73.9% of patients. The undertreatment rate of cardiovascular risk factors, such as blood pressure, low-density lipoprotein cholesterol, haemoglobin A1c and smoking status, was 35.8%, 59.0%, 45.3% and 5.3%, respectively.
CONCLUSIONConventional atherosclerosis risk factors were common among Thai patients with established atherosclerotic disease. Even though most of the patients received recommended treatments according to established guidelines, a significant proportion of them were undertreated for atherosclerosis risk factors.
2.Ten-year survival and factors associated with increased mortality in patients admitted for acute decompensated heart failure in Thailand.
Rungroj KRITTAYAPHONG ; Prasart LAOTHAVORN ; Kriengkrai HENGRUSSAMEE ; Sopon SANGUANWONG ; Rapeephon KUNJARA-NA-AYUDHYA ; Kasem RATTANASUMAWONG ; Chulaluk KOMOLTRI ; Piyamitr SRITARA
Singapore medical journal 2020;61(6):320-326
INTRODUCTION:
Data on the long-term outcomes of Asian patients admitted for acute decompensated heart failure is scarce. The objectives of this study were to determine short-term, intermediate-term and long-term survival among patients admitted for acute decompensated heart failure in Thailand, and to identify factors independently associated with increased mortality.
METHODS:
Patients who were admitted with a primary diagnosis of heart failure were enrolled in the Thai Acute Decompensated Heart Failure Registry (ADHERE) from 18 hospitals located across Thailand during 2006. Medical record data was collected according to ADHERE protocol. Mortality data was collected from death certificates on file at the Thailand Bureau of Registration Administration.
RESULTS:
A total of 1,451 patients were included. The mean age of the patients was 63.7 ± 14.4 years, and 49.7% were male. One-year, five-year and ten-year mortality rates in Thai patients admitted for acute decompensated heart failure were 28.0%, 58.2% and 73.3%, respectively. Independent predictors of increased mortality were identified. There were more cardiovascular-related deaths than non-cardiovascular-related deaths (54.6% vs. 45.4%, respectively).
CONCLUSIONS
The ten-year mortality rate in Thai patients admitted for acute decompensated heart failure was 73.3%. Many factors were found to be independently associated with increased mortality, including left ventricular ejection fraction.