1 in 7 heart failure patients died within 90 days of hospitalisation, finds ICMR

Aditi Tandon

New Delhi, August 14

The first pan-India study tracking mortality burden in patients of acute heart failure has revealed that one in seven died during the first 90 days of follow-up, after they were hospitalised and the disease affected all strata of people irrespective of income levels. In-hospital mortality in the study was found to be one in 15 patients.

Ischaemic heart disease was the predominant factor in three of the four patients in the study that involved 10,851 patients of Acute Decompensated Heart Failure (ADHF) enrolled with the National Registry of Heart Failure across 53 tertiary hospitals in 21 states and four UTs between 2019 and 2020.

The authors followed all patients for 90 days and made key findings — heart failure equally affects the low and high socio-economic strata in India.

“For example, one of four heart failure patients in the registry reported either no or less than four years of formal schooling. It was striking that the 90-day mortality is the highest in individuals with low educational status with a clear inverse relationship between educational level and mortality,” Indian Council of Medical Research’s Meenakshi Sharma, one of the study authors, told The Tribune. Mean age of the 10,851 ADHF patients in the Indian study was 59.9 years, with 31 per cent of all patients being women.

The study sought to gather evidence of mortality trends in patients of ADHF — a clinical syndrome of new or worsening signs and symptoms of heart failure that often lead to hospitalisation or an emergency department visit.

It found that while one in seven died during the 90-day follow up, only one in two patients received Guideline-Directed Medical Therapy (GDMT). The patients were enrolled from January 2019 to July 2020 and tracked for 90 days.

“Overall, the 90-day mortality was 14.2 per cent (14.9 per cent and 13.9 per cent in women and men, respectively). In-hospital mortality was 7.6 per cent and 6.7 per cent in women and men, respectively,” Sharma said.

Affects 26 mn people worldwide

• Heart failure is a complex clinical syndrome often arising from impairment of ventricular filling or ejection of blood
• Estimated to affect 26 million people worldwide, is disabling and deadly with an annual hospitalisation of one million US adults
• Data on heart failure patients is limited in India