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【心衰国际学院】Yoo Byung Su教授:如何利用住院治疗优化心力衰竭药物和设备治疗


在“2018深圳心力衰竭国际发展论坛暨心力衰竭治疗研讨会·深圳站”会议上,来自延世大学元州医学院的Yoo Byung Su教授为我们带来了'How hospitalization can be used for the optimization of heart failure drug and device therapy(如何利用住院治疗优化心力衰竭药物和设备治疗)'的精彩报告。



Outlines


  • Background

  • Key component of optimized HF management during hospitalization

  • Device implantation

  • Summary

Population aged 65 and older


Projected prevalence of HF in USA and Korea


Increasing Prevalence, Hospital Admission and Cost


The majority of healthcare costs for HF patients in Korea was related to hospitalization


Heart Failure (HF) is a Disease of High Mortality – Korean HF Registry Data


Predictors of In-hospital Mortality


Validation of the MAGGIC HF risk score for predicting mortality : similar result 


Post-discharge, the prognosis is poor


Mortality is particularly high in the early phase after hospitalization


Rehospitalization is particularly high in the early phase after hospitalization:


The burden of HF each hospitalization = start of a new vulnerable phase


Hospitalization is the key moment to optimize treatment


Hospitalization is the key moment to optimize treatment


Optimize heart failure care--from hospital discharge to patient follow-up


Several Organization for PM


ACCF/AHA/AMA-PCPI 2011 HF Performance Measures:  Inpatient


ACCF/AHA/AMA-PCPI 2011 Performance Measures: Outpatient


Reality: Use of evidence based medication in hospitalized patients


rug adherence and outcomes in hospitalized patients with HFrEF


SUrvey of Guideline Adherence for Treatment of Hospitalized Systolic Heart Failure Patients  in Real World (SUGAR)


Clinical Outcomes : De novo HF vs. ADHF


Clinical Outcomes and Discharge Medication as Guideline Adherence Indicator (GAI)


Early post-discharge assessment is key: further adjustments to therapy will be required


Hospitalization is the key moment to optimize treatment to prevent post-discharge mortality and rehospitalization


Major Trials of ICD for 1° Prevention


ICD implantation per million inhabitants in European country


ICD implantation in Asia


ICD & CRT in Korea


Disparity Between Indications for and Utilization of Implantable device in Asian Patients With Heart Failure.


Long-Term Prognosis of Patients with an Implantable Cardioverter-Defibrillator in Korea


CRT Response Rate in Korea


ICD Indication and Mortality


Analysis of Possible Candidates for ICD


IDC implantation vs. Outcomes


IMPROVE HF Patient Process Measures


ACCF/AHA/AMA-PCPI 2011 Performance Measures: Outpatient -- inpatient in Asia


Impact of the Improve the Use of Evidence-Based Heart Failure Therapies


Incremental Benefit with HF Therapies(Cumulative % Reduction in Odds of Death at 24 Months Associated with Sequential Treatments)


New Horizon


Trends in the Rate of Sudden Death across Trial Groups over Time


Ongoing Prospective Study in Korea


Conclusions


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