Publications by authors named "Tiew-Hwa Katherine Teng"
A Prospective Observational Study Study Period: 2012-09 to 2020-03 Study Data Overview (ASIAN HF Registry, A Prospective Observational Study [ASIANHF]; NCT01633398).
View Article and Find Full Text PDFAims: To compare the effectiveness of sodium-glucose cotransporter 2 (SGLT2) inhibitors and dipeptidyl peptidase 4 (DPP-4) inhibitors in reducing haemoglobin A1c (HbA1c) variability and improving cardiovascular and renal outcomes in patients with type 2 diabetes mellitus (T2DM) and high HbA1c variability.
Methods: This territory-wide cohort study involved patients with T2DM and an HbA1c variability score (HVS) >60% who initiated SGLT2 inhibitors or DPP-4 inhibitors in Hong Kong between 2015 and 2022. Propensity score (PS) matching was used to adjust for confounders.
Remnant cholesterol, identified by triglyceride-rich lipoprotein, is a significant causal risk factor for ischemic heart diseases. The association of triglyceride levels with all-cause and cause-specific outcomes in heart failure (HF) remains unexplored. Using a previously validated territory-wide clinical information registry, all eligible patients diagnosed with HF (N = 127124) from 2000 to 2020 were included.
View Article and Find Full Text PDFBackground: Heart Failure (HF) quality of care (QoC) is associated with clinical outcomes. Therefore, we investigated differences in HF QoC across worldwide regions (with differing national income) and the association of quality indicators with outcomes.
Methods: We examined the quality of care (QoC) in acute heart failure (HF) patients across different regions using quality indicators (QIs) from the European Society of Cardiology (ESC) and the American Heart Association (AHA) to evaluate QoC.
Heart failure (HF) epidemiology, patient characteristics, and clinical outcomes exhibit substantial regional variations, reflecting diverse etiologies and health system capacities. This review comprehensively analyses these variations, drawing on data from recent global registries and clinical trials. Our review indicates that ischemic and hypertensive heart diseases are prevalent globally but differ in dominance depending on the region.
View Article and Find Full Text PDFHeart failure with improved versus persistently reduced left ventricular ejection fraction: A comparison of the BIOSTAT-CHF (European) study with the ASIAN-HF registry.
Eur J Heart Fail
December 2024
Article Synopsis
- The study examined heart failure patients with initially low ejection fractions who later showed improvement, identifying about 20% of these individuals achieving a significant increase in heart function after 9 months.* -
- Patients with improved ejection fraction experienced lower rates of rehospitalization and mortality compared to those with persistently low function, with consistent results found in two separate patient registries.* -
- Five key predictors for improvement were identified: female sex, absence of ischemic heart disease, higher initial ejection fraction, and smaller heart sizes, allowing the development of a predictive model to better assess who may improve.*
Article Synopsis
- The study aimed to explore how serial measurements of NT-proBNP, a heart failure biomarker, relate to cardiac changes and patient outcomes, considering various clinical factors.
- Analysis involved 1911 heart failure patients, revealing that NT-proBNP levels generally declined, especially in certain groups like inpatients and those on guideline-recommended medications.
- An increase in NT-proBNP over time was linked to a higher risk of hospitalization or death, with variations noted based on patient age, atrial fibrillation presence, and heart failure types.
Background: Heart failure (HF) and dementia frequently co-exist with shared pathological mechanisms and risk factors. Our study aims to investigate the association between statin therapy and the risks of dementia and its subtypes among patients with HF.
Methods: The Hong Kong Clinical Data Analysis and Reporting System database was interrogated to identify patients with incident HF diagnosis from 2004 to 2018, using ICD 9/ICD 10 codes.
Article Synopsis
- Heart failure with normal ejection fraction (HFnEF) is relatively unexplored compared to other forms of heart failure, prompting researchers to study its characteristics and outcomes.
- In a study of 1,765 patients, a significant portion had HFnEF, distinguishing them from those with preserved but low ejection fraction by factors like lower coronary artery disease rates and differing echocardiographic patterns.
- Understanding the varied cardiac features among HFnEF patients might help develop more tailored treatment strategies for those with heart failure with preserved ejection fraction (HFpEF).
Risk of hyperkalaemia in patients with type 2 diabetes mellitus prescribed with SGLT2 versus DPP-4 inhibitors.
Eur Heart J Cardiovasc Pharmacother
January 2024
Aims: To investigate the risk of hyperkalaemia in new users of sodium-glucose cotransporter 2 (SGLT2) inhibitors vs. dipeptidyl peptidase-4 (DPP-4) inhibitors among patients with type 2 diabetes mellitus (T2DM).
Methods And Results: Patients with T2DM who commenced treatment with an SGLT2 or a DPP-4 inhibitor between 2015 and 2019 were collected.
Background: Diabetes mellitus (DM), chronic kidney disease (CKD), and heart failure (HF) are pathophysiologically linked and increasing in prevalence in Asian populations, but little is known about the interplay of DM and CKD on outcomes in HF.
Objectives: This study sought to investigate outcomes in patients with heart failure with preserved ejection fraction (HFpEF) vs heart failure with reduced ejection fraction (HFrEF) in relation to the presence of DM and CKD.
Methods: Using the multinational ASIAN-HF registry, we investigated associations between DM only, CKD only, and DM+CKD with: 1) composite of 1-year mortality or HF hospitalization; and 2) Kansas City Cardiomyopathy Questionnaire scores, according to HF subtype.
Background: In heart failure (HF), symptoms and health-related quality of life (HRQoL) are known to vary among different HF subgroups, but evidence on the association between changing HRQoL and outcomes has not been evaluated.
Objectives: The authors sought to investigate the relationship between changing symptoms, signs, and HRQoL and outcomes by sex, ethnicity, and socioeconomic status (SES).
Methods: Using the ASIAN-HF (Asian Sudden Cardiac Death in Heart Failure) Registry, we investigated associations between the 6-month change in a "global" symptoms and signs score (GSSS), Kansas City Cardiomyopathy Questionnaire overall score (KCCQ-OS), and visual analogue scale (VAS) and 1-year mortality or HF hospitalization.
Article Synopsis
- Heart failure (HF) is linked to an increased risk of developing dementia, as both conditions share common risk factors.
- In a study of over 202,000 HF patients from 1995 to 2018, about 11% experienced new-onset dementia, with Alzheimer's being the most common type.
- Factors such as older age, being female, and having other health issues like Parkinson's or stroke were identified as key predictors of dementia, which further increased the risk of death in these patients.
Purpose: Non-adherence to heart failure (HF) medications is associated with poor outcomes. We used restricted cubic splines (RCS) to assess the continuous relationship between adherence to renin-angiotensin system inhibitors (RASI) and β-blockers and long-term outcomes in senior HF patients.
Methods: We identified a population-based cohort of 4234 patients, aged 65-84 years, 56% male, who were hospitalised for HF in Western Australia between 2003 and 2008 and survived to 1-year post-discharge (landmark date).
Aims: We investigated titration patterns of angiotensin-converting enzyme inhibitors (ACEis)/angiotensin receptor blockers (ARBs) and beta-blockers, quality of life (QoL) over 6 months, and associated 1 year outcome [all-cause mortality/heart failure (HF) hospitalization] in a real-world population with HF with reduced ejection fraction (HFrEF).
Methods And Results: Participants with HFrEF (left ventricular ejection fraction <40%) from a prospective multi-centre study were examined for use and dose [relative to guideline-recommended maintenance dose (GRD)] of ACEis/ARBs and beta-blockers at baseline and 6 months. 'Stay low' was defined as <50% GRD at both time points, 'stay high' as ≥50% GRD, and 'up-titrate' and 'down-titrate' as dose trajectories.
Article Synopsis
- The study evaluated the mismatch between how heart failure patients perceived their health (measured using the Kansas City Cardiomyopathy Questionnaire or KCCQ) and how physicians assessed their condition (using the New York Heart Association or NYHA classification).
- Out of 4818 patients, around 43% were aligned in having good health statuses, while significant portions displayed poor alignment, indicating serious discrepancies, especially with worse outcomes linked to these differences.
- Improved patient-reported health scores over six months were associated with better outcomes, highlighting the importance of considering patient perspectives in managing heart failure.
Article Synopsis
- The study aimed to analyze the connection between chronic kidney disease (CKD) and heart failure (HF) in patients with new-onset type 2 diabetes (T2DM) and their effects on mortality risk.
- A large cohort of over 102,000 patients was followed for several years, revealing that while CKD was more common, HF was linked to a higher risk of death; around 21.7% of CKD patients had HF, and 34.6% of HF patients had CKD.
- The findings underscore the importance of monitoring both CKD and HF in T2DM patients since having either condition significantly increases the risk of mortality, particularly when both are present.
Article Synopsis
- Frailty is prevalent among Asian heart failure patients, with about 69% categorized as frail, and is associated with older age and specific ethnicities like Malay and Southeast Asian.
- The study followed nearly 3,900 participants for one year and found that higher frailty was linked to increased risks of death or hospitalization due to heart failure, with frail patients having significantly worse outcomes.
- The impact of frailty on outcomes varied by race, being strongest among Chinese patients, but did not differ significantly based on sex or heart failure type.
Article Synopsis
- * Historically seen in elderly, hypertensive women, recent research highlights diverse clinical characteristics and mechanisms among HFpEF patients.
- * Understanding these differences is crucial for early diagnosis, treatment, and identifying risk factors for preventive measures across various demographics.
Article Synopsis
- A systematic review and meta-analysis were conducted to evaluate sex differences in treatment responses to heart failure medications, particularly focusing on men and women with reduced ejection fraction (HFrEF).
- The study analyzed 618 articles, ultimately including 25 randomized controlled trials with over 100,000 patients, examining outcomes like all-cause mortality and heart failure hospitalizations.
- Results showed no significant differences in treatment effects by sex for key medications like renin-angiotensin system inhibitors and beta-blockers, suggesting that both men and women respond similarly to these heart failure therapies.
Left atrial (LA) structure and function in heart failure with reduced (HFrEF) versus preserved ejection fraction (HFpEF) is only established in small studies. Therefore, we conducted a systematic review of LA structure and function in order to find differences between patients with HFrEF and HFpEF. English literature on LA structure and function using echocardiography was reviewed to calculate pooled prevalence and weighted mean differences (WMD).
View Article and Find Full Text PDFBackground Data on rehospitalizations for heart failure (HF) in Asia are scarce. We sought to determine the burden and predictors of HF (first and recurrent) rehospitalizations and all-cause mortality in patients with HF and preserved versus reduced ejection fraction (preserved EF, ≥50%; reduced EF, <40%), in the multinational ASIAN-HF (Asian Sudden Cardiac Death in Heart Failure) registry. Methods and Results Patients with symptomatic (stage C) chronic HF were followed up for death and recurrent HF hospitalizations for 1 year.
View Article and Find Full Text PDFAims: The number of patients with both chronic obstructive pulmonary disease (COPD) and heart failure (HF) is increasing in Asia, and these conditions often coexist. We previously revealed a tendency of beta-blocker underuse among patients with HF with reduced ejection fraction (HFrEF) and COPD in Asian countries other than Japan. Here, we evaluated the impact of cardio-selective beta-blocker use on the long-term outcomes of patients with HF and COPD.
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