Abstract：
OBJECTIVE: Data on the burden of acute heart failure (AHF) admissions, practice patterns, and outcomes are rare from India and other low- and middle-income countries. We aimed to describe the baseline characteristics, guideline-directed medical therapy (GDMT) prescribing patterns and 90-day mortality rates in patients admitted with AHF in Kerala, India.
RESULTS: The Cardiology Society of India-Kerala Acute Heart Failure Registry (CSI-KHFR) is an observational registry from 50 hospitals in Kerala, India, with prospective follow-up. Consecutive patients with AHF, who consented to participate, were enrolled. The 2016 European Society of Cardiology criteria were used for the diagnosis of AHF. Kaplan-Meier survival analysis and Cox-proportional hazard models were used for data analysis. The variables in the MAGGIC risk score were used in the multivariable model. A total of 7507 patients with AHF (37% female) participated in the CSI-KHFR. The mean age was 64.3 (12.9) years. More than two-third had reduced ejection fraction (EF) (67.5%). Nearly one-fourth (28%) of patients with heart failure (HF) with reduced EF received GDMT. Overall, in-hospital and 90-day mortality rates were 7% and 11.6%, respectively. Prescriptions of different components of GDMT were independently associated with 90-day mortality.
CONCLUSIONS: The CSI-KHFR recorded an in-hospital and 90-day mortality of 7% and 11.6%, respectively. Only one of four patients received GDMT. AHF mortality was independently associated with GDMT initiation. Quality improvement initiatives that focus on increasing GDMT prescription may improve the survival of HF patients in India.
RESULTS: The Cardiology Society of India-Kerala Acute Heart Failure Registry (CSI-KHFR) is an observational registry from 50 hospitals in Kerala, India, with prospective follow-up. Consecutive patients with AHF, who consented to participate, were enrolled. The 2016 European Society of Cardiology criteria were used for the diagnosis of AHF. Kaplan-Meier survival analysis and Cox-proportional hazard models were used for data analysis. The variables in the MAGGIC risk score were used in the multivariable model. A total of 7507 patients with AHF (37% female) participated in the CSI-KHFR. The mean age was 64.3 (12.9) years. More than two-third had reduced ejection fraction (EF) (67.5%). Nearly one-fourth (28%) of patients with heart failure (HF) with reduced EF received GDMT. Overall, in-hospital and 90-day mortality rates were 7% and 11.6%, respectively. Prescriptions of different components of GDMT were independently associated with 90-day mortality.
CONCLUSIONS: The CSI-KHFR recorded an in-hospital and 90-day mortality of 7% and 11.6%, respectively. Only one of four patients received GDMT. AHF mortality was independently associated with GDMT initiation. Quality improvement initiatives that focus on increasing GDMT prescription may improve the survival of HF patients in India.
摘要：
目的：关于急性心力衰竭（AHF）入院负担的数据，实践模式，印度和其他低收入和中等收入国家的结果很少见。我们旨在描述基线特征，喀拉拉邦AHF患者的指南指导药物治疗（GDMT）处方模式和90天死亡率，印度。
结果：印度心脏病学会-喀拉拉邦急性心力衰竭登记处（CSI-KHFR）是来自喀拉拉邦50家医院的观察性登记处，印度,有前瞻性的后续行动。连续AHF患者，谁同意参加，已注册。2016年欧洲心脏病学会标准用于AHF的诊断。使用Kaplan-Meier生存分析和Cox比例风险模型进行数据分析。MAGGIC风险评分中的变量用于多变量模型中。共有7507名AHF患者（37％为女性）参加了CSI-KHFR。平均年龄为64.3(12.9)岁。超过三分之二的人的射血分数（EF）降低（67.5％）。近四分之一（28％）的EF降低的心力衰竭（HF）患者接受了GDMT。总的来说,住院和90天死亡率分别为7%和11.6%，分别。GDMT不同成分的处方与90天死亡率独立相关。
结论：CSI-KHFR记录了7%和11.6%的住院和90天死亡率，分别。四名患者中只有一名接受了GDMT。AHF死亡率与GDMT启动独立相关。以增加GDMT处方为重点的质量改进计划可能会提高印度HF患者的生存率。
结果：印度心脏病学会-喀拉拉邦急性心力衰竭登记处（CSI-KHFR）是来自喀拉拉邦50家医院的观察性登记处，印度,有前瞻性的后续行动。连续AHF患者，谁同意参加，已注册。2016年欧洲心脏病学会标准用于AHF的诊断。使用Kaplan-Meier生存分析和Cox比例风险模型进行数据分析。MAGGIC风险评分中的变量用于多变量模型中。共有7507名AHF患者（37％为女性）参加了CSI-KHFR。平均年龄为64.3(12.9)岁。超过三分之二的人的射血分数（EF）降低（67.5％）。近四分之一（28％）的EF降低的心力衰竭（HF）患者接受了GDMT。总的来说,住院和90天死亡率分别为7%和11.6%，分别。GDMT不同成分的处方与90天死亡率独立相关。
结论：CSI-KHFR记录了7%和11.6%的住院和90天死亡率，分别。四名患者中只有一名接受了GDMT。AHF死亡率与GDMT启动独立相关。以增加GDMT处方为重点的质量改进计划可能会提高印度HF患者的生存率。
