Background: The efficacy and safety profile of tolvaptan in heart failure (HF) patients have been demonstrated in the previous studies. We investigated real world data in the five Japanese hospital from the Asian Sudden Cardiac Death in Heart Failure (ASIAN-HF) registry. Methods: The ASIAN-HF registry was a prospective observational registry of symptomatic patients with HFrEF from 44 centers in 11 Asian regions. In the Japanese cohort, 66 (9.7%) patients used of tolvaptan (TLV group) whereas 612 (90.3%) did not (non-TLV group). We compared clinical characteristics between two groups and evaluated 1-year mortality. Results: Clinical characteristics including hypertension, renal insufficiency and left ventricular ejection function (LVEF) were not different between two groups. TLV group had significantly higher age, New York Heart Association (NYHA), BNP and a history of atrial fibrillation than non-TLV group (68.8 vs. 65.3 years, 2.3 vs. 2.1, 519.0 vs. 304.9 pg/ml and 62.1 vs. 36.6%). Systolic blood pressure and serum sodium were significantly lower TLV group than non-TLV-group (108.7 vs. 115.4 mmHg and 138.3 vs. 139.7 meq/L). After 1:2 propensity matching (for age, sex, NYHA and LVEF), TLV group (n = 53) was higher cardiac death than non-TLV group (n = 106) (9.4 vs. 3.8%, P < .05 by log-rank test). Conclusions: TLV was used in severe HF patients in the ASIAN HF registry Japanese cohort.
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