Heart failure, regardless of rEF or pEF, is a progressive condition that needs urgent, optimal intervention1-4

Early treatment optimisation can help reduce the risk of CV death or hospitalisation

HF-Image-Zoom
HF-Image-Zoom

  • ACM=all-cause mortality; CV=cardiovascular; eGFR=estimated glomerular filtration rate; HF=heart failure; HRQoL=health-related quality of life; pEF=preserved ejection fraction; rEF=reduced ejection fraction.

  1. Shah KS, Xu H, Matsouaka RA, et al. Heart failure with preserved, borderline, and reduced ejection fraction: 5-year outcomes. J Am Coll Cardiol. 2017;70(20):2476-2486.

  2. Schwinger RHG. Pathophysiology of heart failure. Cardiovasc Diagn Ther. 2021;11(1):263-276.

  3. Abdin A, Anker SD, Butler J, et al. 'Time is prognosis' in heart failure: time-to-treatment initiation as a modifiable risk factor. ESC Heart Failure. 2021;8(6):4444-4453.

  4. Maddox TM, Januzzi JL, Allen LA, et al. 2024 ACC expert consensus decision pathway for treatment of heart failure with reduced ejection fraction. J Am Coll Cardiol. 2024;83(15):1444-1488.

  5. Nair R, Lak H, Hasan S, Gunasekaran D, Barbar A, Gopalakrishna KV. Reducing all-cause 30-day hospital readmissions for patients presenting with acute heart failure exacerbations: a quality improvement initiative. Cureus. 2020;12(3):e7420.

  6. Bytyçi I, Bajraktari G. Mortality in heart failure patients. Anatol J Cardiol. 2015;15(1):63-68.

  7. Sepehrvand N, Savu A, Spertus JA, et al; Alberta HEART Investigators. Change of health-related quality of life over time and its association with patient outcomes in patients with heart failure. J Am Heart Assoc. 2020;9(17):e017278.

  8. House AA, Wanner C, Sarnak MJ, et al; Conference Participants. Heart failure in chronic kidney disease: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney Int. 2019;95(6):1304-1317.

Unmet needs: According to national heart failure registry1

For patients who get hospitalized for an acute decompensated heart-failure:

  • Nearly 1 out of every 7 such patients will die within 90-days of initial hospital admission

  • Nearly 1 out of every 12 such patients will require a re-hospitalization within 90-days of initial hospital admission.

  • Initiation of guideline-directed medical therapy at hospital-discharge, results in significantly improved clinical outcomes over 90-days

HF-graph-image-fig-1

NHFR data

 

  • 10 851 ADHF patients

  • 53 centres across 21 states

     

Key findings

 

  • GDMT for HFrEF = 47.5%

  • GDMT for HFmrEF = >33.3%

  • In-hospital mortality = 6.7%

  • ADHF=acute decompensated heart failure; GDMT=guideline-directed medical therapy; HFmrEF=heart failure with mildly reduced ejection fraction; HFpEF=heart failure with preserved ejection fraction; HFrEF=heart failure with reduced ejection fraction.

  1. Harikrishnan S, Bahl A, Roy A, et al. NHFR Investigators. Clinical profile and 90 day outcomes of 10851 heart failure patients across India: National Heart Failure Registry. ESC Heart Fail. 2022;9(6):3898-3908.

Findings call for innovative quality improvement initiatives to improve the uptake of GDMT in our HF patients