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Clinical features, management, and short‐ and long‐term outcomes of patients with acute decompensated heart failure: phase I results of the HEARTS database
Author(s) -
AlHabib Khalid F.,
Elasfar Abdelfatah A.,
Alfaleh Hussam,
Kashour Tarek,
Hersi Ahmad,
AlBackr Hanan,
Alshaer Fayez,
AlNemer Khalid,
Hussein Gamal A.,
Mimish Layth,
Almasood Ali,
AlHabeeb Waleed,
AlGhamdi Saleh,
Alsharari Mubrouk,
Chakra Esmail,
Malik Asif,
Soomro Raza,
Ghabashi Abdullah,
AlMurayeh Mushabab,
Abuosa Ahmed
Publication year - 2014
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1002/ejhf.57
Subject(s) - medicine , acute decompensated heart failure , heart failure , interquartile range , ejection fraction , diabetes mellitus , blood pressure , cardiology , renal function , mortality rate , endocrinology
Aims The HEart function Assessment Registry Trial in Saudi Arabia ( HEARTS ) is a national multicentre project, studying clinical features, management, short‐ and long‐term outcomes, and mortality predictors in patients admitted with acute decompensated heart failure ( ADHF ). Methods and results Our prospective registry enrolled 2610 ADHF patients admitted to 18 hospitals in Saudi Arabia between October 2009 and December 2010, and followed mortality rates until January 2013. The patients included 66% men and 85.5% Saudis, with a median age (interquartile range) of 61.4 (15) years; 64% had acute on chronic heart failure ( HF ), 64.1% diabetes mellitus, 70.6% hypertension, and 55.7% CAD . Exacerbating factors for hospital admission included acute coronary syndromes (37.8%), infections (20.6%), non‐compliance with low‐salt diet (25.2%), and non‐compliance with HF medications (20%). An LVEF <40% was found in 73%. In‐hospital use of evidence‐based medications was high. All‐cause cumulative mortality rates at 30 days, 6 months, 1 year, 2 years, and 3 years were 8.3, 13.7, 19.5, 23.5, and 24.3%, respectively. Important independent predictors of mortality were history of stroke, acute on chronic HF , systolic blood pressure <90 mmHg upon presentation, estimated glomerular filtration rate <60 mL /min, and haemoglobin <10 g/ dL . Conclusion Patients with ADHF in Saudi Arabia presented at a younger age and had higher rates of CAD risk factors compared with those in developed countries. Most patients had reduced LV systolic function, mostly due to ischaemic aetiology, and had poor long‐term prognosis. These findings indicate a need for nationwide primary prevention and HF disease management programmes.