Plasma biomarkers levels, essential for diagnosing cardiovascular diseases, may vary by ethnicity. In this international prospective study, we compared plasma biomarker levels between European and Asian patients with clinically similar acute heart failure (AHF). Data were collected on emergency admission for acute dyspnea. Blood samples were obtainedwithin 4 hrs of presentation and analyzed for N-terminal pro-B-type natriuretic peptide (NTproBNP), high-sensitivity troponin-T, growth differentiation factor 15, interleukin-6, and C-reactive protein levels. Overall, 907 AHF patients were enrolled; of which, 135 (15%) wereJapanese, and 772 (85%) were European. NT-proBNP levels were significantly higher inHôpital Lariboisière, Bat Viggo Petersen, Porte 5 au 2ème étage, 43 boulevard de la chapelle, Paris 75010, FranceJapanese than in Europeans [4,060 ng/L (interquartile range (IQR) 2,081–12,218) vs.3,390 ng/L (IQR 1,410–7,682), P = 0.004]. After propensity score matching (PSM), no bio-marker levels differed significantly. After stratification according to left ventricular ejection fraction (LVEF) at admission, higher NT-proBNP levels were observed in Japanese AHF pa-tients with LVEF > 50% (P = 0.02) than in European patients. After PSM, the difference was insignificant (P = 0.35). In Asian and Caucasian AHF patients with similar clinical profiles, plasma cardiovascular biomarker levels did not differ significantly, regardless of LVEF, sug-gesting that NT-proBNP and related biomarkers can be applied across these ethnicities.

Acute heart failure (AHF) is a life-threatening medical condition, where urgent diagnostic and treatment methods are of key importance. However, there are few evidence-based treatment methods. Interestingly, despite relatively similar ways of management of AHF throughout the globe, mid-term outcome in East Asia, including South Korea is more favorable than in Europe. Yet, most of the treatment methods are symptomatic. The cornerstone of AHF management is identifying precipitating factors and specific phenotype. Multidisciplinary approach is important in AHF, which can be caused or aggravated by both cardiac and non-cardiac causes. The main pathophysiological mechanism in AHF is congestion, both systemic and inside the organs (lung, kidney, or liver). Cardiac output is often preserved in AHF except in a few cases of advanced heart failure. This paper provides guidance on AHF management in a time-based approach. Treatment strategies, criteria for triage, admission to hospital and discharge are described.
Cardiac Output ; Estrogens, Conjugated (USP) ; Europe ; Far East ; Heart Failure ; Heart ; Kidney ; Korea ; Phenotype ; Precipitating Factors ; Shock, Cardiogenic ; Triage