Clinical characteristics, management and outcomes of patients with chronic heart failure: Results from the heart function assessment registry trial in Saudi Arabia (HEARTS-chronic)

Int J Cardiol. 2017 May 15:235:94-99. doi: 10.1016/j.ijcard.2017.02.087. Epub 2017 Feb 24.

Abstract

Background: Several registries have described patients hospitalized with heart failure (HF), but only few looked at outpatients in the ambulatory setting mostly without long-term follow-up. We sought to determine the clinical characteristics, management, and 1-year outcomes of patients with chronic HF in Saudi Arabia.

Methods: Part of a prospective multicenter nationwide registry; HEart function Assessment Registry Trial in Saudi Arabia (HEARTS) and included chronic HF patients referred to four HFCs between September 2009 and December 2011.

Results: We enrolled 685 patients with mean age 55.66±15.97years, 70.1% were men and 96.1% were Saudis. The main etiologies of HF were CAD (38.8%), dilated cardiomyopathy (36.5%), and hypertension (10.5%). Severe left ventricular dysfunction was present in 70.6% and median NT-proBNP was 2934.37pg/ml. The prescription rates of evidence based therapies (EBTs) before admission to HFC, at discharge from 1st clinic visit, and at 1-year follow up were 90%, 91% and 94% for beta-blockers, 79%, 80%, and 86% for ACEi/ARBs and 44%, 45%, and 42% for aldosterone antagonists; respectively. ICD was inserted in 21.9% and CRT in 6.6% at enrollment and increased to 29.1% and 8.8% after one year respectively. The all-cause mortality rate at 1year was 9% and 93.7% of which was cardiac-related. The all-cause one-year hospitalization rate was 39% and the total emergency room visit rate was 50%.

Conclusions: Chronic HF patients in Saudi Arabia are younger, commonly have severe LV systolic dysfunction and have relatively high annual mortality and re-hospitalization rates.

Keywords: Chronic heart failure; Middle East; Registry.

Publication types

  • Multicenter Study

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Adult
  • Aged
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
  • Cardiomyopathy, Dilated / complications*
  • Chronic Disease
  • Female
  • Heart Failure* / etiology
  • Heart Failure* / mortality
  • Heart Failure* / physiopathology
  • Heart Failure* / therapy
  • Hospitalization / statistics & numerical data
  • Humans
  • Hypertension / complications*
  • Male
  • Middle Aged
  • Mineralocorticoid Receptor Antagonists / therapeutic use*
  • Mortality
  • Natriuretic Peptide, Brain / analysis
  • Outcome and Process Assessment, Health Care
  • Peptide Fragments / analysis
  • Registries / statistics & numerical data
  • Saudi Arabia / epidemiology
  • Severity of Illness Index
  • Symptom Assessment / methods
  • Symptom Assessment / statistics & numerical data
  • Ventricular Dysfunction, Left / diagnosis
  • Ventricular Dysfunction, Left / etiology

Substances

  • Adrenergic beta-Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Mineralocorticoid Receptor Antagonists
  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain