Heart Failure Patient Profiles, Management and Outcome: Results from a Heart Failure Clinic Registry

Background: Heart failure (HF) is characterised by frequent decompensation and an unpredictable trajectory. The prevalence of heart failure has increased from 43.4 to 46.5% in the last 10 years in lower and middle-income countries like Bangladesh. This study aims to describe baseline clinical profiles, management strategies, and the in-hospital outcome of patients visited hospital for HF. Methods: A retrospective observational study was conducted on HF patients at a tertiary care hospital in Bangladesh. Relevant data were collected from patients’ medical records. Results: A total of 1536 patients with HF were included in our study. Of those, most were male (84%) and older than 55 years (62%) (mean (±SD) 53.2±6.5 years). A significant improvement was observed in the patients' functional status as defined by The New York Heart Association (NYHA) class. A total of 35 patients had a history of heart block, and 94% of them had first-degree blocks. Nearly two-thirds of patients (73%) had a history of heart failure with reduced ejection fraction (HFrEF). A significant change was observed in the patients' 6-minute walk test. Most common comorbid conditions were associated coronary artery disease (59%) followed by renal failure (17%). Hypertension (67%) and diabetes (55%) were the most common coronary risk factors. 1246 patients (81%) were diagnosed as ischemic patients. Beta blocker (88%), diuretic (72%), SGLT2 inhibitors (63%), and ARNI (49%) were most common medication. Overall, 78 patients received device where 54 patients (66%) used ACID and 28 (34%) used CRTD. A total of 226 patients died, 72% from cardiovascular and 28% from non-cardiovascular causes. Conclusions: There was a high prevalence of co-morbid diseases and aetiologies among patients with HF, including hypertension and ischemia. The study sheds light on what continues to impact hospitalized HF patients' morbidity and mortality, aiding meaningful interventions to improve patient outcomes.