Lakshmi Hospital, Palakkad, Kerala, India.
Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India.
Int J Cardiol. 2022 Jun 1;356:73-78. doi: 10.1016/j.ijcard.2022.03.021. Epub 2022 Mar 13.
Acute decompensated heart failure (ADHF) is a challenging medical emergency with high mortality and its prevalence is increasing in India. There is paucity of data on ADHF in the country.
Indian College of Cardiology National Heart Failure Registry (ICCNHFR) is an on-going observational registry on ADHF contributed by 22 hospitals across India; and we present the in-hospital and 30-day outcomes of ADHF patients enrolled from August 2018 to July 2019. Major objective included capturing demographics, comorbid conditions, aetiology, prescription patterns and assessing clinical outcomes.
Of 5269 patients (mean age: 61.90 ± 13.85 years) enrolled in this study, males were predominant (67.09%). Mean duration of hospitalization was 5.74 ± 4.74 days. Ischemic heart disease was the most common (75.44%) aetiology. Abnormal electrocardiogram readings were found in most patients (89.86%). LVEF of ˂40% was found in 68.29% of patients. In-hospital mortality rates were 6.98%. The 30-day cumulative mortality was 12.35% and 30-day rehospitalization rate was 7.98%. At discharge, all guideline-based medical therapy (GDMT) were prescribed only to 24.99% of patients and 23.72% adhered to the prescription until 30 days. Older age, high serum creatinine levels and poor LVEF contributed to high mortality and rehospitalization.
Patients with ADHF were younger and predominantly males. Usage of GDMT in ADHF patients was low (24.99%) and the in-hospital mortality was high. Older age, high serum creatinine levels, poor LVEF contributed for 30-day mortality and rehospitalization. This data on ADHF, could help in developing strategies to improve outcomes for HF patients in India.
急性失代偿性心力衰竭（ADHF）是一种具有高死亡率的挑战性医疗急症，其在印度的患病率正在上升。印度缺乏 ADHF 的相关数据。
印度心脏病学会国家心力衰竭登记处（ICCNHFR）是一项正在进行的 ADHF 观察性登记处，由印度各地的 22 家医院参与；我们报告了 2018 年 8 月至 2019 年 7 月期间登记的 ADHF 患者的住院期间和 30 天结局。主要目标包括收集人口统计学、合并症、病因、处方模式和评估临床结局。
本研究共纳入 5269 例患者（平均年龄：61.90±13.85 岁），男性占多数（67.09%）。平均住院时间为 5.74±4.74 天。缺血性心脏病是最常见的病因（75.44%）。大多数患者的心电图读数异常（89.86%）。68.29%的患者 LVEF ˂40%。住院期间死亡率为 6.98%。30 天累积死亡率为 12.35%，30 天再住院率为 7.98%。出院时，仅 24.99%的患者接受了所有基于指南的药物治疗（GDMT），而 23.72%的患者在 30 天内遵循了处方。年龄较大、血清肌酐水平较高和左心室射血分数较低与较高的死亡率和再住院率相关。
ADHF 患者较年轻，男性居多。ADHF 患者 GDMT 的使用率较低（24.99%），住院期间死亡率较高。年龄较大、血清肌酐水平较高、左心室射血分数较低与 30 天死亡率和再住院率相关。这些 ADHF 数据可能有助于制定改善印度心力衰竭患者结局的策略。
