Demographic and Clinical Real-life Pattern in a Contemporary Cohort of Egyptian Patients with Heart Failure at Northern Cairo

Background: Heart failure (HF) is a complex clinical syndrome classified into heart failure with reduced (HFrEF), mildly reduced (HFmrEF), and preserved ejection fraction (HFpEF). It remains a major cause of morbidity and mortality worldwide, particularly in Egypt, where cardiovascular diseases are prevalent. This study aims to assess the demographic and clinical characteristics of Egyptian heart failure patients in a contemporary cohort at Mataria Educational Hospital, Northern Cairo. Methods: This cross-sectional study was conducted on 500 HF patients (310 HFrEF, 115 HFmrEF, 75 HFpEF). Data were collected through structured interviews, clinical assessments, echocardiography, and relevant laboratory investigations. Results: HFrEF was more common in males (68.7%) and associated with lower eGFR (72 ±26 ml/min, P = 0.008), higher revascularization rates (P = 0.001), and greater beta-blocker (93.2%, P < 0.001) and ARNI use (12.4%, P < 0.001). HFpEF was more prevalent in females (70.9%) and associated with higher systolic blood pressure (132 ±16 mmHg, P < 0.001) and left ventricular hypertrophy (92.7%, P < 0.001). SGLT2 inhibitors, particularly dapagliflozin, were more commonly used in HFpEF (92.7%, P < 0.001). Cost barriers significantly limited ARNI and SGLT2 inhibitor use across all HF subtypes. Conclusion: Ischemic heart disease is the predominant cause of HF in Egypt. The underutilization of guideline-recommended therapies due to cost highlights the need for accessible treatment options. Tailored management strategies based on HF phenotypes are crucial to optimizing patient outcomes in the Egyptian population.