Clinical profile of congestive heart failure in super speciality tertiary care hospital - Insights from a heart failure clinic

Abstract: BACKGROUND: Heart failure (HF) has emerged as a significant public health concern in our country, characterised by high morbidity, mortality, and compromised quality of life, making it a prevalent cardiovascular disease. OBJECTIVES: This study aimed to investigate the clinical profile of HF patients, identify gaps in care, and provide recommendations for improving HF management. METHODOLOGY: A prospective observational study was conducted among adult HF patients attending the dedicated HF clinic in the Department of Cardiology. RESULTS: Over the past year, 4631 HF patients registered at our bi-weekly clinic. The mean patient age was 52.81 ± 12.24 years. Hypertension, coronary artery disease, type 2 diabetes mellitus, valvular heart disease, idiopathic dilated cardiomyopathy, chronic kidney disease, and myocarditis sequelae were the most common etiologies identified. Factors contributing to acute decompensated heart failure (ADHF) included poor medical follow-up, non-adherence to treatment, excessive water intake, uncontrolled hypertension, anaemia, and infections. Limited access to diagnostic investigations in remote areas resulted in delayed diagnosis and progression to advanced New York Heart Association (NYHA) classes. Alarmingly, a significant proportion of patients were not receiving optimal guideline-directed medical therapy (GDMT) at their initial visit. CONCLUSION: The findings of this study, which elucidate the demographic and clinical profile of heart failure patients and highlight gaps in guideline-directed medical therapy (GDMT), offer valuable insights for developing targeted strategies to mitigate the heart failure burden in India. The comprehensive one-year dataset provides a robust foundation for informing policy and practice initiatives aimed at improving HF outcomes, reducing morbidity, and decreasing mortality rates in the Indian population.