Ischemic heart disease
is the leading cause of
in India and the disease burden is more on the younger generation (less than 65 years) when compared to that of other countries, says the first National Heart Failure Registry (NHFR) which was released on Monday.
The study says the 90-day mortality rate in heart failure patients is 17%, which is high when compared to that of cancer. The 7-day mortality among the heart failure patients was 6.4%, 30-day mortality was 12.2% and 90-day mortality was 17.1%.
The study, conducted as part of the registry, found that less than half of the
receive guideline-directed therapy and mortality is reduced among those who have received it. “The higher 90-day mortality in heart failure (HF) patients calls for a nationwide audit and quality improvement initiatives,” says the NHFR.
The NHFR is a multi-centric, hospital-based registry of HF patients, funded by the Indian Council of Medical Research (ICMR). In January 2019, Sree Chitra Tirunal Institute of Medical Sciences was designated as one of the nodal agencies to create a national heart failure registry by the ICMR.
“The NHFR recruited consecutive HF patients from 50 centres (200 patients from each center) across 24 states in India from January 2019. Consecutive patients admitted with the diagnosis of acute decompensated HF conforming to the European Society of Cardiology (ESC) 2016 criteria were enrolled into the registry. We collected demographics, clinical, laboratory, imaging, and other diagnostic data at baseline from all registered patients in the registry by using a structured document,” said NHFR co-ordinator Dr S Harikrishnan, who is also the national principal investigator.
As part of this, the team analyzed the data of first consecutive 6,437 patients who have completed the 90-day follow-up in the NHFR. The mean age of the study population was 60.5 years and men comprised more than two-third of the population (68.8%).
Heart failure with reduced ejection fraction was the most common form of presentation (65.6%), followed by HF with mid-range ejection fraction and HF with preserved ejection fraction.
If the heart muscle is too weak, the condition is known as heart failure with a reduced ejection fraction (HFrEF). Ejection fraction is used to assess the pump function of the heart; it represents the percentage of blood pumped from the left ventricle per beat.
Ischemic heart disease was the predominant etiology for HF (73%), followed by dilated cardiomyopathy in 17.2% of the population. Rheumatic valvular heart disease was prevalent in 5.9% of the study population, said Dr Harikrishnan.
Hypertension and diabetes were the most frequent co-morbid conditions for heart failure (48.5% and 44.4%, respectively). Tobacco use is 33.2%, atrial arhythmia was prevalent in 10.5%, while
chronic kidney disease
frequency was 9% in the study population.