Design and preliminary results of the Heart Function Assessment Registry Trial in Saudi Arabia (HEARTS) in patients with acute and chronic heart failure†

Abstract

AimsThe heart function assessment registry trial in Saudi Arabia (HEARTS) is the first multicentre national quality improvement initiative in the Arab population to study the clinical features, management, and outcomes of inpatients admitted with acute heart failure (AHF) and outpatients with high-risk chronic heart failure (HCHF). Methods and resultsWe conducted a prospective pilot phase for the registry that included consecutive patients with AHF and HCHF in five tertiary care hospitals in Saudi Arabia between October 2009 and December 2010. The study enrolled 1090 patients, 722 (66.2%) of whom were admitted with AHF and 368 (33.8%) had HCHF. The mean age + SD of AHF patients was 60.6 + 15.3 years; 65.2% were men, 55.3% were de novo heart failure, 60.7% had diabetes mellitus, 72.5% had moderate or severe left ventricular (LV) systolic dysfunction, and 51.5% had coronary artery disease as the main aetiology. More than 80% of AHF and HCHF patients were treated with beta-blockers and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers. Patients with HCHF had a similar clinical profile, but only onethird had implantable cardioverter defibrillators. In-hospital mortality was 5.3% for AHF patients and 7.5% at 30 days after hospital discharge. ConclusionHeart failure patients in Saudi Arabia present at a relatively younger age, have a much higher rate of diabetes mellitus, and predominantly have LV systolic dysfunction, which is mainly ischaemic in origin, compared with patients in developed countries. The preliminary results of the study show potential targets for improvement in care.--

Long-Term Mortality Rates in Acute De Novo Versus Acute-on-Chronic Heart Failure

“…[7][8][9][10][11][12][13][14][15][16][17][18] Only scarce data are available regarding HF in Arab populations, which have different ethnic and cultural backgrounds. [19][20][21][22][23] Furthermore, only a few recent comparative studies have reported long-term mortality rates beyond 1 year from hospital discharge for patients with de novo AHF and ACHF.…”

Epidemiologic Transition and Heart Failure in Black African Adults

“…Europe [20] [21] [22]. In sub-Saharan Africa, it has been known for many decades that less than 30% of hospitalized patients at the cardiac intensive care unit have diabetes [21].…”

How To Improve Time To Diagnosis In Acute Heart Failure — Clinical Signs And Chest X-Ray

“…In Eastern Europe, Asia, Africa and the Middle East, patients are much more likely to present acutely with de novo HF. [46][47][48][49][50] Patients in Saudi Arabia are younger, with a higher incidence of diabetes and a greater preponderance for left ventricular systolic dysfunction. 50 Patients in the Asian-Pacific are also younger, less co-morbid and tend to exhibit a more severe phenotype.…”

“…[46][47][48][49][50] Patients in Saudi Arabia are younger, with a higher incidence of diabetes and a greater preponderance for left ventricular systolic dysfunction. 50 Patients in the Asian-Pacific are also younger, less co-morbid and tend to exhibit a more severe phenotype. 49 Finally, across a range of sub-Saharan African countries the incidence of ischaemic heart disease is much lower than in western populations with hypertension the predominant HF aetiology.…”