Clinical characteristics and outcomes of patients admitted with acute heart failure: insights from a single-center heart failure registry in South India

Abstract

Background The epidemiology of HF in India is largely unexplored. Current resources are based on a few hospital-based and a community-based registry from North India. Thus, we present the data from a single hospital-based registry in South India. Patients admitted with acute heart failure over a period of 1 year were enrolled in the registry and were characterized based on their ejection fraction (EF) measured by echocardiogram. The clinical profile of the patients was assessed, including their in-hospital outcomes. One-way ANOVA and univariate analysis were performed for comparison between three EF-based groups and for the assessment of in-hospital outcomes. Results A total of 449 patients were enrolled in the registry, of which 296, 90, and 63 patients were categorized as, HFrEF, HFmrEF, and HFpEF, respectively. The prevalence of HFrEF was higher (65.99%). The mean age (SD) of the study cohort was 59.9±13.3. The majority of the patients presented with acute denovo HF (67%) and were more likely to be males (65.9%). The majority of patients presented with warm and wet clinical phenotype (86.4%). In hospital mortality was higher in HFmrEF (3.3%). Conclusion Patients with HFrEF had high adherence to guideline-directed medical therapy (GDMT). HFrEF patients were also likely to have longer hospital stay along with a worsening of renal function. The in-hospital mortality was comparable between the EF-based groups. Additionally, the association of clinical phenotypes with outcome highlighted that patients in warm and wet phenotype had a longer length of hospital stay, whereas the mortality and worsening renal function rates were found to be significantly higher in the cold and wet group.

Prevalence of cardiac abnormalities and heart failure in unselected out-patients with type 2 diabetes mellitus and associated clinical factors: Real-world evidence from an Indian registry

“…A single-center HF registry from South India demonstrated T2DM as the most prevalent comorbidity in HFrEF (62.8 %) and HFmrEF (56.6 %) groups compared to the HFpEF group (34.9 %; p < 0.001). 25 Another study from South India reported a much higher prevalence of HFpEF in patients with HF and T2DM (91.2 % versus 43.5 %) compared to patients with HF and without T2DM. 24 The higher proportion of HFmrEF and HFrEF across the HF subgroups in these studies could be due to the inclusion of patients with or without T2DM and HF while we excluded the patients with previously diagnosed HF, CAD, or prior incidence of myocardial infarction.…”

“… 21 Many Indian studies have determined the prevalence of either systolic/diastolic LV dysfunction or HF in patients with and without T2DM 22 , 23 , 24 and assessed the real-world scenario of clinical profile and clinical practice among patients with HF. 25 , 26 However, there is a scarcity of robust large-scale studies evaluating the prevalence of early stages of HF in patients with T2DM, particularly in India. 25 , 27 , 28 Therefore, this registry-based study was conducted to determine the prevalence of LV dysfunction and HF in unselected individuals with T2DM attending outpatient clinics and evaluated their association with comorbidities and other clinical characteristics in India.…”

“… 25 , 26 However, there is a scarcity of robust large-scale studies evaluating the prevalence of early stages of HF in patients with T2DM, particularly in India. 25 , 27 , 28 Therefore, this registry-based study was conducted to determine the prevalence of LV dysfunction and HF in unselected individuals with T2DM attending outpatient clinics and evaluated their association with comorbidities and other clinical characteristics in India.…”

The Power and Promise of Angiotensin Receptor Neprilysin Inhibitor (ARNI) in Heart Failure Management: National Consensus Statement

“…Myriads of associated comorbid conditions worsen the prognosis of HF, with associated several million hospitalizations and a major economic burden worldwide. 13 Worldwide, an estimated 64.3 million people have HF. The prevalence of recognized HF is typically considered to be between 1 and 2% of the general adult population in affluent countries.…”

Management of Heart Failure in a Resource-Limited Setting: Expert Opinion from India

“…Comorbidities varied, with coronary artery disease prevalent in 52.5%, type 2 diabetes in 62.8% and 56.6% for HFrEF and HFmrEF, respectively, and hypertension in 48% for HFpEF. Chronic kidney disease was reported in 13% of patients with heart failure [ 7 ].…”