Heart failure in the Middle East
Main Author: Mohamed Hassan
Despite striking improvement in the prognosis and survival in patients with coronary artery disease (CAD), hypertension, and congenital heart disease, the prevalence of heart failure (HF) is still growing.1–3 HF is the most common cause of hospitalization after normal delivery – approximately 1 million patients are hospitalized annually for HF in the United States.4 Moreover, the prognosis of HF is relatively poor, with 25% mortality at 1 year and 50% mortality at 5 years (stage D HF: 80% mortality at 5 years) – worse than that of many cancers.1,2 The clinical profile, and outcome of HF in western population is well demonstrated after the release of several large registries such as Acute Decompensated Heart Failure National Registry (ADHERE) and the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE-HF). 5–7 Based on data from ADHERE registry, lower systolic blood pressure (BP), elevated serum BUN and creatinine, hyponatremia, older age, presence of dyspnea at rest, and absence of chronic beta-blocker were identified as independent predictors of mortality.5,6 On the other hand, data on the prevalence and outcome of stroke in patients hospitalized for HF are very scarce and mainly driven from studies conducted in developed countries. Moreover, little systematic data exist regarding the clinical profile and management of HF patients in the Middle East population that have different ethnic, cultural, and socio-economic background. Hence, the Gulf Heart Association initiated and finalized the Gulf Acute Heart Failure Registry (Gulf CARE) to provide the first systematic report of the characteristics of acute HF (AHF) patients in this region.