Clinical profile and one-year survival of patients with heart failure with reduced ejection fraction: The largest report from India
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Date
2019-05
Journal Title
Journal ISSN
Volume Title
Publisher
Cardiological Society of India
Abstract
Background
India has one of the largest population of heart failure (HF) patients in the world; yet only limited information is available about HF in India.
Methods
This observational study was performed at Medanta- The Medicity, a large, tertiary-care institute in the National Capital Region of India. Records of HF patients with reduced left ventricular ejection fraction (LVEF) registered at Medanta HF clinic during the period early 2014 to mid-2017 were reviewed. Disease characteristics and one-year mortality details were collected.
Results
Mean age of the subjects (n = 5590) was 59.1 ± 11.8 years with 83.0% males. Mean LVEF was 30.0 ± 6.6%. Coronary artery disease (CAD) was the dominant cause of HF, accounting for 77.8% of the total population. Most patients received guideline-directed medical therapy with a beta blocker being prescribed to 81.8% subjects. The one-year all-cause mortality was 17.6%. On multivariate analysis, age, usage of loop diuretics and ivabradine, and serum creatinine were independently associated with one-year mortality, whereas rheumatic etiology had an inverse association.
Conclusions
This represents the largest single-center data of HF patients reported so far and the largest study describing clinical outcomes from HF patients in India. Our patients were younger, had high proportion of CAD, and there was higher usage of beta-blockers. Despite this, the one-year mortality was substantial. Given the enormous magnitude of HF burden in India and the paucity of information on this subject, these findings should be of help in identifying key problem areas and potential solutions for management of HF in India.
Description
Keywords
Heart failure, Heart failure with reduced ejection fraction, Heart failure with preserved ejection fraction, Ambulatory heart failure, Beta blockers, Cardiovascular disease
Citation
Chopra Vijay K., Mittal Sanjay, Bansal Manish, Singh Balbir, Trehan Naresh. Clinical profile and one-year survival of patients with heart failure with reduced ejection fraction: The largest report from India. Indian Heart Journal. 2019 May; 71(3): 242-248