PCV57 THE BURDEN OF HEART FAILURE IN NORTH AMERICA AND WESTERN EUROPE

Abstract

With population aging and improvements in ischemic heart disease (IHD) survival, the number of heart failure (HF) cases have risen dramatically over the last few decades in developed countries. We present the burden of acute heart failure (AHF) hospitalizations and chronic heart failure (CHF) prevalence in North America and Western Europe in 2019, using a cyclical flow diagram of adult patients from diagnosis/hospitalization until disease stabilization, decompensation, and/or death. We estimated the AHF hospitalization incidence due to de novo and decompensated events and the diagnosed prevalence of CHF in the mature pharmaceutical markets of North America and Western Europe using national hospitalization databases and population-based studies, respectively. We applied the correlation function between the disability adjusted life-years (DALYs) calculated for the major etiological factors of HF, i.e. IHD, rheumatic heart disease, cardiomyopathy, myocarditis, endocarditis, and valvular heart disease, and HF incidence/prevalence in the above countries (R2=0.78 and 0.62 for AHF and CHF, respectively), to estimate the number of AHF events/CHF cases in the countries for which there were no reliable data. The drug-treated percentages for CHF were estimated from primary/secondary research. In 2019, we estimate more than 3.5 million AHF hospitalizations and 7.4 million diagnosed prevalent cases of CHF in North America. In Western Europe, the corresponding numbers were 5.1 million hospitalizations and 8.5 million CHF cases. Of the CHF cases, 86% and 88% were drug-treated, respectively. Approximately 38% of CHF patients were categoried as NYHA Class III/IV in both regions. In 2019, the most widely-prescribed class of drugs for CHF in North America were β-blockers (69%) and in Western Europe, loop diuretics (75%). HF takes a tremendous toll on the healthcare systems in the developed world. The substantially high number of hospitalizations and prevalent cases call for greater implementation public health policies to prevent IHD.