Heart failure (HF) has a dark prognosis due to the high rate of mortality and re-hospitalization. The aim of our study was to compare the HF- ischemic versus non- ischemic in order to identify the prognosis impact of the etiology.

A prospective and comparative study including 150 patients, hospitalized for HF with ejection fraction <40% in cardiology department from 2013 to 2016, and subdivided into two groups. Group A (n=65, ischemic HF) and group B (n=85, non-ischemic HF).

Group A patients were older and had significantly more frequent history of diabetes dyslipidemia and tobacco, renal failure and anemia were more common in group A. Atrial fibrillation (AF) and left bundle branch block were more often noted in the group B. Both groups were comparable according to echocardiography parameters and prescription of beta-blockesr, Spironolactone and Angiotensin-converting enzyme inhibitors. However, more patients from group B underwent cardiac resynchronization and cardioverter-defibrillator implantation. Hospital mortality and 6 months mortality was 6% and 13% and was higher in group A. Re-hospitalization and MACE rate was similar in both groups. Ischemic etiology of HF was predictor of mortality with (HR=1.9, P<0.01). In multivariate analysis, age (HR=3, P<0.01), diabetes (HR=3, P<0.01), pulmonary artery systolic pressure (PASP) ≥45mmg (HR=8, P<0.01) and the non prescription of BB were associated with a high risk of mortality. Independent prognosis factors comparable between both groups were: age, pulmonary arterial pressure ≥45mm Hg, dyspnea class IV of NYHA and the non-prescription of BB. However, RF was specific factors for group A and: EF<30%, AF and TAPSE<12mm were specific for group B.

The ischemic etiology seems to have a worse prognosis compared to other etiologies. In order to evaluate the global prognosis, and since prognosis factors are different and related to the etiology.