Characteristics of patients admitted with heart failure: Insights from the first Malaysian Heart Failure Registry

Abstract

Aims: Heart failure (HF) is a growing health problem, yet there are limited data on patients with HF in Malaysia. The Malaysian Heart Failure (MY-HF) Registry aims to gain insights into the epidemiology, aetiology, management, and outcome of Malaysian patients with HF and identify areas for improvement within the national HF services.

Methods and results: The MY-HF Registry is a 3-year prospective, observational study comprising 2717 Malaysian patients admitted for acute HF. We report the description of baseline data at admission and outcomes of index hospitalization of these patients. The mean age was 60.2 ± 13.6 years, 66.8% were male, and 34.3% had de novo HF. Collectively, 55.7% of patients presented with New York Heart Association (NYHA) Class III or IV; ischaemic heart disease was the most frequent aetiology (63.2%). Most admissions (87.3%) occurred via the emergency department, with 13.7% of patients requiring intensive care, and of these, 21.8% needed intubation. The proportion of patients receiving guideline-directed medical therapy increased at discharge (84.2% vs. 93.6%). The median length of stay (LOS) was 5 days, and in-hospital mortality was 2.9%. Predictors of LOS and/or in-hospital mortality were age, NYHA class, estimated glomerular filtration rate, and comorbid anaemia. LOS and in-hospital mortality were similar regardless of ejection fraction.

Conclusions: The MY-HF Registry showed that the HF population in Malaysia is younger, predominantly male, and ischaemic-driven and has good prospects with hospitalization for optimization of treatment. These findings suggest a need to reassess current clinical practice and guide resource allocation to improve patient outcomes.

Keywords: Acute decompensated heart failure; Baseline demographics; Guideline‐directed medical therapy utilization; In‐hospital outcome.

Figure 1

(A) Primary HF aetiologies at admission and (B) common comorbidities of patients admitted for acute decompensated heart failure. Comorbidities present in <5% of the cohort (chronic obstructive pulmonary disease, sleep‐disordered breathing, cerebrovascular disease, peripheral artery diseases, previous stroke, and pulmonary hypertension) are detailed in Supporting Information, Table S2 . ^†Idiopathic cardiomyopathy characterized as dilated (n = 303), hypertrophic (n = 10), restrictive (n = 2), chemo‐induced (n = 3), and others (n = 21); missing data (n = 18). ^‡Includes hypertension (n = 157), diabetes (n = 40), idiopathic (n = 18), and others (n = 13); data not available/missing (n = 12). AF, atrial fibrillation/flutter; CKD, chronic kidney disease; HFpEF, heart failure with preserved ejection fraction; IHD, ischaemic heart disease.