<b>Modifiable Risks and Heart Failure Subtypes in Ischemic Heart Disease: An Algerian Multi-Center Retrospective Study</b>

<b>Abstract</b>Ischemic heart disease (IHD) remains the leading cause of global cardiovascular mortality, driven by modifiable risk factors such as hypertension, tobacco use, and type 2 diabetes (T2D), with heart failure (HF) as a major complication. This multi-center retrospective cohort study analyzed 7,216 patients from three tertiary cardiology centers (2017–2025) to quantify associations between IHD, its risk factors, and HF subtypes. Hypertension exhibited the strongest correlation with IHD (adjusted odds ratio [aOR] 4.1, 95% CI 3.4–4.9), followed by tobacco use (aOR 3.2) and T2D (aOR 2.7). IHD conferred a 4.8-fold elevated HF risk, predominantly HF with reduced ejection fraction (HFrEF, 62.1%). Population-attributable risk calculations suggested 38% of IHD cases could be prevented through optimal hypertension control. The study underscores the imperative for aggressive risk factor management to mitigate IHD incidence and its progression to HF. Limitations include retrospective design and exclusion of biomarkers, warranting prospective validation.