Elsevier

American Heart Journal

Volume 159, Issue 6, June 2010, Pages 949-955.e1
American Heart Journal

Trial Design
Acute decompensated heart failure syndromes (ATTEND) registry. A prospective observational multicenter cohort study: Rationale, design, and preliminary data

https://doi.org/10.1016/j.ahj.2010.03.019Get rights and content

Acute heart failure syndromes (AHFS) are likely to increase in the future, and the high readmission rate of patients with AHFS is an important issue in Western countries. However, there are very few published epidemiological studies on AHFS in the Asia Pacific region. Because AHFS are heterogeneous, the characteristics, clinical profile, and management of AHFS should be clarified in an epidemiological study. The acute decompensated heart failure syndromes (ATTEND) registry is a prospective, observational, multicenter cohort study being performed in Japan and is the first epidemiological study of AHFS in the Asia Pacific region. This study is designed to investigate several aspects of AHFS as follows: (1) the registry allows patient-based data collection for precise evaluation of patient characteristics and short-term outcomes, including the readmission rate; (2) confirmation of clinical assessments can be performed, and new clinical assessments can be created; and (3) feedback allows the modification of guidelines for clinical management. The present report describes the clinical characteristics of patients with AHFS in Japan based on the preliminary data collected in this study, and the similarities and differences in characteristics of these patients compared with those in Western countries. Although most of the patient characteristics did not differ from those reported in Western studies, there are some unique findings in this study, including a high rate of treatment with carperitide (69.4%) and angiotensin II receptor blockers (53.9%) at discharge and a longer hospital stay (median 21 days). The ATTEND registry is designed to provide valuable information to clarify the characteristics of patients with AHFS to improve their management.

Section snippets

Study design

The acute decompensated heart failure syndromes (ATTEND) registry is a prospective observational multicenter cohort study that is currently underway in Japan. Patients are enrolled at the first admission and then followed up; thus, data collection is patient based and not event based.

Study objectives

The objectives of the ATTEND registry are to clarify the overall clinical characteristics of patients with AHFS, including (1) demographic characteristics and clinical profile, (2) current treatments, (3)

Clinical profile of AHFS in the present study and comparison to those of Western studies

As of May 18, 2009, a total of 1,110 patients had been enrolled at 29 hospitals. The characteristics of these patients are shown in Table I. The mean age was 73 ± 14 years and 58.9% were men. The percentage of patients with a history of hospitalization for heart failure was lower than that of patients with de novo heart failure (37.4% vs 62.6%). Hypertension was the most common risk factor (70.6%). The underlying diseases that led to AHFS were ischemic heart disease in 33.2%, hypertensive heart

Discussion

To the best of our knowledge, the ATTEND registry is the first epidemiological study of AHFS in the Asia Pacific region. It has provided detailed data on the baseline characteristics and profile of Japanese patients with AHFS (except those with ACS) and has revealed several important differences compared with patients with AHFS in Western countries. The present study not only investigated patient characteristics but also the hemodynamic profile of patients with AHFS. Regarding the etiology of

Acknowledgements

We thank Dr Mihai Gheorghiade for his critical review of our article. We also thank all investigators for their contributions.

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See Appendix online for complete listing of the ATTEND Investigators.

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