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. 2019 Nov 26;71(1):27.
doi: 10.1186/s43044-019-0024-0.

Preliminary results of the acute Heart Failure registry in the DELTA region of Egypt (DELTA-HF): a database and a quality initiative project

Abdelfatah Elasfar  1   2 , Sherif Shaheen  3 , Wafaa El-Sherbeny  3 , Hatem Elsokkary  3 , Suzan Elhefnawy  3 , Mohammed Al-Setiha  3
Affiliations

Preliminary results of the acute Heart Failure registry in the DELTA region of Egypt (DELTA-HF): a database and a quality initiative project

Abdelfatah Elasfar et al. Egypt Heart J. .

Abstract

Background: Data about heart failure in Egypt is scarce. We aimed to describe the clinical characteristics and diagnostic and treatment options in patients with acute heart failure in the Delta region of Egypt and to explore the gap in the management in comparison to the international guidelines.

Results: DELTA-HF is a prospective observational cohort registry for all consecutive patients with acute heart failure (AHF) who were admitted to three tertiary care cardiac centers distributed in the Delta region of Egypt. All patients were recruited in the period from April 2017 to May 2018, during which, data were collected and short-term follow-up was done. A total of 220 patients (65.5% were males with a median age of 61.5 years and 50.9% had acute decompensation on top of chronic heart failure) was enrolled in our registry. The risk factors for heart failure included rheumatic valvular heart disease (10.9%), smoking (65.3%), hypertension (48.2%), diabetes mellitus (42.7%), and coronary artery disease (28.2%). Left ventricular ejection fraction (LVEF) was less than 40% in 62.6%. Etiologies of heart failure included ischemic heart disease (58.1%), valvular heart disease (16.3%), systemic hypertension (9.1%), and dilated non-ischemic cardiomyopathy (15.5%). Exacerbating factors included infections (28.1%), acute coronary syndromes (25.5%), non-compliance to HF medications (19.6%), and non-compliance to diet (23.2%) in acute decompensated heart failure (ADHF) patients. None of our patients had been offered heart failure device therapy and only 50% were put on beta-blockers upon discharge. In-hospital, 30 days and 90 days all-cause mortality were 18.2%, 20.7%, and 26% respectively.

Conclusions: There is a clear gap in the management of patients with acute heart failure in the Delta region of Egypt with confirmed under-utilization of heart failure device therapy and under-prescription of guideline-directed medical therapies particularly beta-blockers. The short-term mortality is high if compared with Western and other local registries. This could be attributed mainly to the low-resource health care system in this region and the lack of formal heart failure management programs.

Keywords: Acute heart failure; Egypt; Quality initiative; Registry.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Etiology of acute heart failure in this patient cohort (n = 220)
Fig. 2
Fig. 2
Exacerbating factors for acute decompensation in this heart failure patient cohort (n = 220)
See this image and copyright information in PMC

References

    1. Savarese G, Lund LH. Global public health burden of heart failure. Card Fail Rev. 2017;3(1):7–11. doi: 10.15420/cfr.2016:25:2. - DOI - PMC - PubMed
    1. Heidenreich PA, Albert NM, Allen LA, et al. Forecasting the impact of heart failure in the United States: a policy statement from the American Heart Association. Circ Hear Fail. 2013;6(3):606–619. doi: 10.1161/HHF.0b013e318291329a. - DOI - PMC - PubMed
    1. Members WG, Benjamin EJ, Blaha MJ, et al. Heart disease and stroke statistics—2017 update: a report from the American Heart Association. Circulation. 2017;135(10):e146. - PMC - PubMed
    1. Fonarow GC. Epidemiology and risk stratification in acute heart failure. Am Heart J. 2008;155(2):200–207. doi: 10.1016/j.ahj.2006.10.043. - DOI - PubMed
    1. Chen J, Normand S-LT, Wang Y, Krumholz HM. National and regional trends in heart failure hospitalization and mortality rates for Medicare beneficiaries, 1998-2008. Jama. 2011;306(15):1669–1678. doi: 10.1001/jama.2011.1474. - DOI - PMC - PubMed

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